Micheál Carrigy (Fine Gael)
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I welcome the Minister of State to the Chamber. On the Order of Business of 29 July, I spoke about the 1,700 independent not-for-profit section 39 organisations that operate in Ireland, and in particular, St. Christopher's Services, which operates in my own area of Longford, and St. Hilda's Services of Athlone. St. Christopher's Services provides day services for 141 adults, full-time residential care for 39 adults, respite care for 50 adults, and day-to-day respite for 15 children.

The biggest challenge facing an organisation such as St. Christopher's Services, which has a staff of 239 full- and part-time members, is retaining staff. In 2019 and 2020, St. Christopher's Services lost 10% of its permanent workforce. Staff are due to receive €1.3 million in cumulative back pay dating back to 2010. The difference in the pay scales of where staff should be, and where they currently are, is a figure of €1.275 million. Many of the staff are being paid under 2013 Department of Health consolidation pay scale rates, rather than the 2019 rates, which means that there is a high level of competition for very skilled workers. St. Christopher's Services is losing many of its staff to other HSE services, section 38 organisations and private providers. This is largely due to the massive discrepancies in pay for section 39 staff. They recruit and train staff, who are then tempted to go and work for section 38 organisations or the HSE, where conditions of service and pay are much better. They want to continue to work within the sector, and, in many cases, within the organisation they already are in, but obviously for financial reasons, they have to move, and we cannot blame them for this. If these organisations cannot retain existing staff or attract new staff, the organisations will not last into the future.

When I spoke in the Seanad I received a high volume of correspondence from staff on the issue. I will now quote some of the comments that were made to me: "changes in staff affecting the users"; "workloads on staff increasing, especially during Covid; "staff are at breaking point"; "we are deemed to be front-line staff, yet we are treated as second class citizens"; "I am on half the pay of my HSE counterpart; it is simply not good enough." It is not good enough.

The independent not-for-profit group, while partly funded by the Government, is accountable to the State, and while standards of accountability, compliance and regular restructures have increased substantially over the past decade, the necessary additional funding to assist this work has not been put in place. These services do not focus on making profits like the private sector, but rather on improving and sustaining our communities and society in general, by building a relationship with users, their families and friends. These workers took pay cuts when we bailed out the banks earlier in this decade, and have been waiting ever since to have their wages restored to parity with their work colleagues in section 38 organisations or the HSE. There is a belief among these organisations that the State does not value their contribution as much as it did in years gone by.

We need to appreciate and cherish our voluntary sector. This means treating those involved with fairness and respect to ensure services are secure for the families and communities that use them. Section 39 organisations provide a range of social care services and other supports nationwide and receive an element of State funding to do so. These are non-profit organisations that provide residential respite and day services to vulnerable people, many of whom are wholly reliant on these services. Among the voluntary organisations are hospices, mental health providers, nursing homes, home care 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. I would like to take this opportunity to commend the many volunteers and board members of these not-for-profit organisations, who provide such a fantastic service, along with the staff, in keeping the services going, particularly in these difficult times.

We must take steps, not only to improve the conditions of those who work so hard on our behalf, but on behalf of those who are dear to each one of us. These organisations make valuable contribution across Irish society and have an 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 agreements. It must put in place the necessary steps to ensure full pay restoration to section 39 workers because that is what they deserve. We are all agreed that we want higher standards in the sector, and there are more people living longer with more complex needs.

I am deeply concerned about the provision of funding, not just for the workers, but for the infrastructure of the services, especially in the area of disabilities and mental health. While the process of pay restoration has commenced, many organisations are in perilous financial situations and are operating at a financial deficit.The Special Committee on Covid-19 Response heard that there were no developments sent to approximately 250 of the other State organisations with regard to funding. The initial 50 organisations were funded. Section 38 guarantees the future of the service indefinitely and provides much-needed reassurance around the correct funding for the service in the years to come.

This issue has been debated in both Houses previously. Various Ministers have been raising this issue since as far back as 2013 or 2014. As Members are aware, the HSE has assured the Department of Health that it is committing to working intensively with such organisations and will support them as appropriate. However, I wish to stress that the time for talking, publishing reports and giving recommendations is done. Action is needed.

Joe O'Reilly (Fine Gael)
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I welcome the Minister of State, Deputy Rabbitte, to the House and congratulate her on her recent appointment.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Leas-Chathaoirleach for his kind words and Senator Carrigy for raising this matter. At the outset, I wish to acknowledge the important services provided by St. Christopher's Services in Longford and the commitment of its staff to people with disabilities and their families. St. Christopher's is a service with which I am very familiar. Several Oireachtas Members have highlighted the important work of the service and what it means to the people of Longford and the surrounding area. It has a long and well-established track record of working with people with intellectual disabilities in the county. Residential services are provided by St. Christopher's to more than 35 service users by way of supported living, independent living and health and social care. As the Senator rightly outlined, day services are provided to more than 140 service users. It also delivers respite services through various models to approximately 50 adults and 14 children.

St. Christopher's Services is a non-statutory organisation funded by the HSE under section 39 of the Health Act 2004. In 2019, it received more than €9.8 million in funding from the HSE. The HSE expects the final funded position in 2020 to exceed that figure. As the Senator will be aware, the HSE is not the sole source of funding for the organisation. I understand that it also receives funding from the Department of Education in respect of St. Christopher's Special School, well as through other channels including fundraising and support from the parents and friends of the organisation. Funding is provided by the HSE for the provision of services in accordance with the terms of the service arrangement agreed yearly with the organisation and is underpinned by section 39 of the Health Act 2004. Organisations funded under that section of the Act receive grant assistance from the HSE to provide services similar or ancillary to services the HSE may provide. This is different from section 38 organisations, which enter into an agreement with the HSE to provide health or personal social services on behalf of the HSE. As of now, there is no established procedure or means by which an organisation can cease to be a service provider funded under section 39 of the Health Act 2004 and become a service provider under section 38 of the Act. Furthermore, section 39 services extend beyond those that provide services for health and social care. As such, changes in the status of such organisations may have broader implications for the State.

Service level agreements are a governance matter for the HSE and the relevant section 39 agency. The Department makes no decision on these matters. In the event of a dispute between the HSE and a section 39 agency, the parties are expected to resolve those differences through mechanisms set out in the service level agreements. I am told that St. Christopher's Services was one of the 50 pilot organisations party to the Workplace Relations Commission, WRC, agreement reached in October 2018 with regard to pay restoration for section 39 organisations. I understand that the WRC pay restoration process for the organisation is completed. Issues surrounding staff pay with regard to section 39 organisations such as St. Christopher's are a matter for those organisations to resolve internally.

Micheál Carrigy (Fine Gael)
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I thank the Minister of State and wish her well in her role. I apologise for not congratulating her earlier. In her concluding remarks, the Minister of State stated that these issues have been resolved but the reality on the ground is that the issues of staff and increments have not been resolved.A significant amount of money is outstanding. I gave the figure earlier. It is over €1 million to which these staff members are entitled. They took these cuts during the downturn in the economy and they are entitled to the return of their increments. An organisation like St. Christopher’s Services that is reliant on a lot of local fundraising to run many of its services is not in a position to pay these increments to staff. It is incumbent on the State to pay them their increments and bring up their pay scales so that the organisation is able to maintain its staff levels. The reality is that if St. Christopher's Services is unable to do that and folds, the HSE will have to provide those services and the staff will be paid at a higher level. I am not happy with the answer. It is incumbent on the Department and the HSE to make sure that these pay scales are brought up.

Anne Rabbitte (Galway East, Fianna Fail)
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The Senator made his point very clearly and eloquently on behalf of St. Christopher's Services and many more organisations across the country. There was a pilot involving 50 of those organisations in 2018 and 2019. It is working its way through the WRC, as I clearly explained. This has not concluded in its entirety. In his speech, the Senator mentioned approximately 250 organisations that find themselves within that remit, of which 110 are from the disability service delivery sector in section 38 and section 39 organisations. It is a very emotive subject for staff who have taken pay cuts and have not received their increments and for providers who can find it very hard to recruit and retain staff while other operators such as the HSE can easily operate. It is in the programme for Government and will be addressed over our term.