Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source

This matter arises on foot of a reply I received on 17 October to a question in respect of section 38 and section 39 organisations which I submitted to the Joint Committee on Health and Children in September. I have in my possession the appendix to the 2012 annual report of the HSE, which indicates that some 2,680 organisations are receiving funding from the executive. The total amount of that funding is €3.27 billion, which is over 25% of the health budget. As already stated, I received a reply on 17 October last to a question I posed in September as to whether moneys additional to those set out in the guidelines laid down by the HSE were being paid. While I was supplied with a generic answer, people in the media seem to have been given many more details two weeks later. However, that is how the political system works and I must accept it.

I am now specifically concerned about the fact that salaries paid out by section 39 organisations do not have to correspond with the guidelines set out for HSE employees. It is in that context that I raise this matter. As already indicated, 2,680 organisations - hospitals, etc. - are receiving funding from the HSE. In view of the debate that has taken place in the past two weeks, will new procedures be put in place in respect of section 39 organisations to ensure both accountability and proper disbursement of the funding allocated? I fully accept that the HSE and the Department of Health are involved in work to revise the position in the area to which I refer. Will the Minister of State indicate where we go from here in respect of this matter?

Fergus O'Dowd (Louth, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I take Senator Colm Burke for raising this important matter. There is a long history of non-statutory service providers providing health and personal social services in Ireland. While many of these organisations have access to financial resources through fund-raising, they rely substantially on the HSE to fund the services the provide. The HSE funds a range of service providers under either section 38 or section 39 of the Health Act 2004. Section 38 arrangements involve the funding of organisations to provide services on behalf of the HSE, while under section 39 the executive grant-aids a wide range of organisations to a greater or lesser extent. As the Senator pointed out, some of the section 39 providers receive very substantial amounts from public funds. Staff of bodies funded under section 38 are classified as public servants and are subject to the standard salary scales for the health sector, as well as having public service pension schemes and being counted in public service employment numbers. Employees of agencies that receive grants from the HSE under section 39 are not public servants and are not specifically subject to the pay scales approved for public servants. I acknowledge the contribution of such service providers to the development of health and personal social services.

The HSE is committed to the development of effective working relationships in line with the provisions of the Health Act 2004, which provides that the executive may, subject to resources and on such terms and conditions as it considers appropriate, fund services provided by non-statutory providers. Significant progress has been made in improving the governance and management framework between the HSE and voluntary service providers. In line with the Comptroller and Auditor General's 2005 report on value for money in the disability sector, a register of non-statutory agencies' service arrangements and grant aid agreements is in operation. This provides local, regional and national management information on more than 2,600 separate agencies which operate more than 4,300 discrete funding arrangements to a value of approximately €3.3 billion. This register is managed by the HSE business support unit and has created a unique identifier for each agency. It allows for the maintenance of key information on each separate funding arrangement, including current and historic funding, compliance with national standards, governance documentation and key contact details.

To ensure that the HSE and the non-statutory sector meet their obligations, the executive has developed a formalised national governance framework with national standard governance documentation to manage the funding. This governance documentation was developed in 2009 with the agreement of all major service providers and came into operation in 2010. Governance documents ensure a national standard consistent application of good governance and eliminate the need for individual contracts to be created each time the HSE funds an agency. This process represents value for money, in that there is a ready-made contract for all funding arrangements, and provides governance that is robust and effective, ensuring that the HSE and the agencies meet their respective obligations. The national suite of documentation is applied according to the nature and scale of the funding and services involved and contains the appropriate corporate, clinical and financial governance requirements. This documentation is the subject of regular review. In 2011 significant changes were introduced, including an extension of the section 38 clause to ensure that only salaries within public sector norms would apply to all funded agencies. In 2013 an additional information return was added to all section 38 and section 39 arrangements. This requires agencies to report separately on all individual staff paid at grade 8 level equivalent or above and provide details on their salaries, including those relating to allowances and any other benefits.

The HSE ensures a continuous focus on compliance with the governance framework and has included this as a key performance indicator for both corporate and regional reporting. At the end of 2012, almost 98% of funding was covered by the governance document.

Given the significance of the sector, all senior management in the Health Service Executive have key responsibilities within the governance framework. A national support structure is in place which includes local and regional heads and a national governance group forum supported by the national business support unit. Various guides and process control forms are maintained alongside a comprehensive operational manual which is in the approval process and awaiting formal adoption.

Since the introduction of the governance framework in 2009, a number of projects have been undertaken to examine the management structures to ensure they are effective. The key recommendations from these projects relate to the need for the HSE to build on the management processes which the national standard governance documentation and operational procedures have established.

Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for his reply. He indicated an additional information return was added to all service arrangements in 2013 requiring agencies to separately report on all individual staff paid at grade 8. I was not informed of this when I received a reply on this matter in October. At that time, it was stated that the Health Service Executive did not have the power to seek such information. Has this information been received from all relevant agencies? In other words, has the new requirement to provide information on all staff at grade 8 or above been complied with?

Fergus O'Dowd (Louth, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Senator Burke is seeking transparency in respect of the requirement to provide information and whether it is has been supplied. As I am not a Minister in the Department, I will ask the Minister to revert to him directly on this important issue.