Victor Boyhan (Independent)
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I warmly welcome the Minister of State, Deputy Rabbitte, to the Seanad. I am raising the issue of St. John of God Community Services in response to a letter I received from Councillor Paddy McQuillan in Louth County Council. He is involved with the service and is a local representative. He circulated to me a letter he received from the chief executive, as did all of the staff and their colleagues, a copy of which I have passed to the Minister of State, dated 30 September 2020.

The substance of this correspondence is that the St. John of God Community Services is to end its involvement in disability and mental health services and transfer all of that responsibility to the HSE. St. John of God services stated that the reason this is happening is because there is an issue with funding. There is a funding crisis that cannot be sustained, in its view. Services have been subsidised by it from other resources, both its personal resources and those of the order which were never collected or intended to be used to subsidise the community services they operate.

As we know, St. John of God provides services for more than 8,000 children, adolescents and adults with intellectual disabilities across Dublin, Kildare, Kerry, Wicklow, Meath and Louth. It employs 3,000 staff and has volunteers in excess of that number. It has 300 locations. More than 2,500 people in receipt of day, residential and respite services will be affected. This is really critical.The order has told me that there is a €27 million annual funding gap and an accumulated deficit of €27.7 million. These are staggering figures. I have spoken to the chief executive of St. John of God Community Services yesterday, Claire Dempsey. I updated myself. I was convinced by my short conversation that there was a genuine willingness on the part of the organisation and the brothers to engage with the Minister of State and the HSE to get a resolution. The Hospitaller Order of St. John of God has a strong track record while having diminishing religious vocations. The order has a rich legacy that has served the State exceptionally well in a wide variety of supports and services.

My concern is firstly for the clients and service users. I am also concerned for the employees who work in these services throughout the country as well as their families and the families of the service users. This is critical.

Funding is an issue and it has to be resolved. It is not a question of a blame game with the HSE versus the Department of Health versus the Hospitaller Order of St. John of God. It is simply that there has to be a sustainable agreement to ensure these services are provided.

There is also an impact because we know the Government policy with regard to congregated settings and breaking up large institutions. We have had enough talk about institutions in recent days to keep us going for years. There are new models and policies of care but they do not come cheap.

There are difficulties and they need to be bridged. I appeal to the Minister of State for her response. People really need to know what is going on, whether we can get these talks back on track and whether we can get an arrangement whereby St. John of God Community Services will consider options with the Minister of State in a constructive way on how to fund these essential services. This is not for the order, the Minister of State or the HSE but for the people who avail of these important care services.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Senator Boyhan for putting down this question. It gives me the opportunity to bring the Senator through my engagement since becoming Minister of State with responsibility for disability matters.

Before I continue, I wish to say this is not a blame game. I could not agree more with Senator Boyhan on that. This is about the service users, their families, the employees and delivering services to the most vulnerable in our society who require these services.

While St. John of God Community Services is in this particular situation regarding funding, we know the disability sector was underfunded for many years. We also know that we have a sustainability issue within the disability sector, where service providers provide a great deal of care. They are not unique in this regard. When we talk to the service providers or anyone within the HSE or the Department, that is exactly what we hear. It is the clear message coming out.

St. John of God Community Services currently provide services to over 2,400 children and adults with intellectual disabilities in community healthcare organisation areas 4,6, 7 and 8. They also provide mental health services and supports to over 5,600 children, adolescents and adults in CHO areas 6 and 7. The HSE has worked closely with the St. John of God organisation over several years to support it in its role and assist it in addressing the financial and governance challenges.

Against this background I held a meeting on 24 September 2020 with representatives of St. John of God which included Department of Health and HSE officials. I outlined my position and plans for the disability sector and encouraged St. John of God to engage with the HSE and address the issues facing the organisation. Nevertheless, following a board meeting of the organisation on the same day, St. John of God formally served the HSE with 12 months' notice of its intention to terminate the provision of services under its section 38 arrangement with the HSE, with a view to transferring responsibility for delivering disability and mental health services to the State by October 2021.

I am keenly aware that the decision of St. John of God may cause anxiety for many of the service users concerned and their families as well as the staff working in the organisation.However, I assure them that there are processes in place to ensure continuity of service provision, which are underpinned by service arrangements between the HSE and St. John of God. St. John of God will continue to be responsible for providing disability and mental health services over the next 12 months. During this period, the HSE will work with St. John of God to put in place suitable arrangements to transfer provision of these services to another appropriate organisation.

St. John of God is required to continue providing services from the effective date of termination or expiry of the 12-month notice period until such time as any new service arrangements become effective. If the 12-month notice period ends and the transfer of services has not yet been finalised, St. John of God is obliged to continue providing the services for up to another six months to allow the transfer to be completed. In effect, the whole process could take up to 18 months. I understand that the HSE also purchases some mental health services from St. John of God on a private basis, which are not governed by the section 38 service arrangement. The HSE is already making provision for community mental health services in Loughlinstown and Dún Laoghaire primary care centres.

The primary concern of this Government is to ensure the continuity of the vital services provided by St. John of God in the interests of service users, families and staff.

Victor Boyhan (Independent)
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I thank the Minister of State for her written reply because it is helpful and we can share it. These are difficult times for all of us in terms of our physical and mental well-being. They are particularly difficult for people with disabilities and the type of people being supported by the St. John of God Community Services. I am encouraged by what the Minister of State said. I will write to the Minister for Health, Deputy Stephen Donnelly, today to ask him if we can see a speeding up of the engagement. We have a timeframe which the Minister of State outlined but it ticks away quite quickly. These are complex issues and big issues in terms of finance.

I welcome the Minister of State's comprehensive and frank layout of what is at stake and I encourage all sides to engage early to ultimately create a better service for users, employees and the communities in which they operate.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy again for raising this matter. I acknowledge and recognise his concerns. It is the first time I have been given the opportunity to put on the record my engagement with St. John of God and my plea to it on that day to not serve notice on us, to work with me, as a Minister of State with responsibility for disabilities, and to give me the opportunity to understand their concerns and to work with the HSE and the Department. It was its prerogative on that day to take the decision it took. I regret it and I do not wish any anxiety or stress to be placed on service users, their families or staff. Over the coming months I will ensure that nobody is left languishing and waiting for answers or responses. Everyone will be left clear and communication will be crystal clear. I will work with the HSE and the Department to ensure there is communication and service users understand exactly what is going on.