Anne Rabbitte (Galway East, Fianna Fail)
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Under section 39 of the Health Act 2004, the Health Service Executive (HSE) provides financial assistance to organisations by means of a grant for the provision of services similar or supplementary to a service that the HSE may provide.

I acknowledge the hugely important role section 39 organisations and their workers play in our health and social care services. They are essential in providing services to many families and vulnerable people in society. In 2022, the HSE provided in excess of €675m to Section 39 providers for Specialist Disability Services.

These organisations are privately owned and run. Their terms and conditions of employment, once in line with employment legislation, are strictly between private sector employers and their employees. While they are private organisations, we recognise their sustainability, and ability to pay staff, is highly dependent on state funding.

I am aware that organisations funded under Section 39 are experiencing challenges in the recruitment and retention of staff. These challenges are mirrored in many of the caring and public facing professions across the State. The sustainability of the sector who deliver valuable services through their staff on our behalf is a concern for both the Department and the HSE. Similar considerations arise in respect of organisations funded by Tusla under Section 56 of Child and Family Agency Act 2013 and in other sectors across Government.

Notwithstanding that the employees of Section 39 organisation are private sector employees with no employment relationship with the HSE, Tusla or my Department, a process of engagement to examine the pay of workers in community and voluntary organisations was committed to by the Government in October last year and we remain fully committed to the process.

On 17 April, officials from my Department, the HSE, Tusla and the Department of Health met with union representatives under the auspices of the Workplace Relations Commission (WRC). This engagement sought to understand and explore the scope of the unions claim for pay rises for Community and Voluntary sector workers.  A follow up engagement took place at the WRC on 15 May. None of the organisations attending the exploratory talks is the employer of the staff in question. As this is an ongoing facilitated process I am limited in what I can say, however I want to see matters effectively and quickly resolved in the interests of services users and providers.

It is important to note that this is a broader cross-sectoral issue, so individual components cannot be dealt with in isolation.

Unlike the position for capital expenditure, where multi annual commitments are made within the National Development Plan, the Estimates process for current expenditure allocates funding on an annual (single- year) basis and no formal mechanism currently exists to provide funding on a multi-annual basis to providers. However, the Minister notes a commitment by the Health Service Executive to seek to introduce this for disability funding within the HSE Corporate Plan 2021-24 and a discussion paper published by the Department of Public Expenditure in relation to the possible future introduction of multi annual funding for other votes. In this regard, the Minister is open to exploring avenues to consider how multi annual funding might be introduced in the future for disability services.

My colleague the Minister for Health is the sponsor of the Health Acts, so the question of any review of the legislation is primarily a matter for him and his department.

In terms of ongoing engagement, I also want to highlight to role of the Dialogue Forum with Voluntary Organisations was established in 2019 by the then Minister for Health with the aim of building a stronger working relationship between the State and the voluntary healthcare sector for the benefit of patients and service users. The Forum facilitates regular dialogue with the voluntary sector on future policy and strategic developments. The Forum recently developed and agreed a set of Partnership Principles. These provide the foundation for the future relationship between the State and the voluntary sector and demonstrate a shared commitment to strengthening this relationship. The Partnership Principles are available at: www.gov.ie/en/publication/fda1d7-dialogue-forum-with-voluntary-organisations/#key-forum-documents.