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Cuts in disability and related services

There were exchanges in both the Dail and Seanad on budget cutbacks in the health services, focussed on the respite care services provided by the Brothers of Charity.

Enda Kenny (FG, Mayo) drew attention to 60 organizations providing services for the intellectually disabled who were now being forced to reduce services or cut them out entirely, having an enormous impact on those involved, their parents, friends and families (Dail Eireann, Debates, 30th June 2010, 1-3).  The Taoiseach responded by saying that the government spent more than €1bn on intellectual disabilities.  There were 178 service providers, with 90% funds given to 25 of them.  The important point, given that there were limited resources generally and against a background of increased resources, was that there was enough money at the frontline.  There must be changes in how organizations cooperated, he said.   Why should there be 25 different payroll systems, why should there be different approaches by various organizations? he asked.  The Brothers of charity had obtained about €125m and the Sisters of Charity about €100m.

In the Seanad, Fidelma Healy Eames (FG, labour ) questioned the assurances of the Taoiseach and the minister of state John Moloney that there would be not cuts, for she was informed that cuts would be 45%, with community houses closed and day care services reduced (Seanad Eireann, Debates, 13th July 2010, 491-3).  There was ‘enormous confusion and uncertainty’.    She described the government’s ‘attack’ on the disabled as ‘cruel’.

Responding for the government, the Minister for Social Protection, Eamon O Cuiv, told her that the government provided €176.9m for the Brothers of Charity, up from  €39.6m in 2005.  The HSE had advised all agencies providing services of required adjustments in their 2010 financial allocations and these were for staff pay reductions in line with national guidelines, the moratorium on recruitment and a 2% efficiency saving applied to non-frontline services such as non-pay, transport, rationalizing management, merging service functions, merging service providers without impacting on users of such services.  The HSE was required to apply these efficiencies across all service areas within the HSE and organizations funded, such as the Brothers of Charity.

His colleague, the Minister of State at the Department of Health and Children with responsibility for disability and mental health, John Moloney met the HSE assistant national director responsible for disability services on several occasions in recent weeks to discuss the emerging challenges in the sector.  The HSE was asked to confirm that the reduction in financial allocations to voluntary agencies was applied consistently and to validate the methodology used to calculate reductions for the various agencies.   There would be no question of exempting voluntary service providers, for that would undermine the strategic objectives of the government policy to reduce staffing levels and achieve payroll savings.  The minister and minister of state met the Brothers of Charity on 7th July together with senior departmental and HSE officials to discuss the maintenance of frontline services and the outcome was clear understanding to work in partnership to resolve the issues.

Fidelma Healy Eames countered that the minister was in effect saying that the cuts would be implemented.   This year 26 staff in the service would retire and not be replaced.  How can we protect these services? she asked.  The minister would only be able to pursue the matter when further information was received from the HSE: ‘we are all committed to ensure frontline services are maintained’. ‘The minister has not reassured me’, she said.

Enda Kenny returned to the issue on 7th July, the day on which people were marching to Leinster House to protest (Dail Eireann, Debates, 7th July 2010, 1-7, 13,  184-9).  Last year, the National Federation of Voluntary Bodies had agreed to cuts of €15m, plus the public sector pay reductions.  The HSE was unable to control its costs in other areas where there were overruns, so it came back and took another €11m from the voluntary sector and that was why people were marching.  He asked the Taoiseach to take executive action ‘to put an end to this madness’.

Responding, the Taoiseach Brian Cowen  told him that the Minister for Health and Children and her Minister of State John Moloney were meeting the Brothers of Charity.  He had indicated that there were other savings to be achieved in management, layers of management, human resource systems, purchasing and procurement.  The government had increased spending by 400%, with €1.2bn provided, of which €900m went to intellectual disability and €300m to physical and sensory disabilities.  He criticized the opposition for portraying a fiction that we could maintain services on the basis of existing service delivery arrangements, but this was not possible and therefore we needed to be prepared to implement changes to the non frontline delivery of services in as many areas as possible to protect to the greatest extent we can those who require services.  Later, the Minister of State, John Moloney, told the Dail that he had implemented a value-for-money review to ensure that savings would remain in front line services.  The €1.6bn allocated to the service provided adequate resources to continue respite care.

Separately, deputies asked about the funding for national networks and voluntary organizations due to expire at the end of 2010.  The Minister for Community, Equality and Gaeltacht Affairs, Pat Carey, told Sean Barrett (FG, Dun Laoghaire) that his department’s officials were reviewing the scheme and expected to complete the process in the autumn and he would then consider options (Dail Eireann, Debates, 24th June 2010, 707).  All organizations in the scheme were being consulted and he planned that week to meet their representative group Voices that matter.

> Sisters of Charity services: Seanad Eireann, 28th June 2010, 698-700.  See also Dail Eireann, Debates, 22nd june 2010, 12-15; 190-1

> Cystic Fibrosis services: Dail Eireann, Debates, 7th July 2010, 173-184

> Funding of drug treatment services in Limerick: Dail Eireann, Debates, 22nd June 2010, 115-117

> IMPACT report on job losses in voluntary and community sector: Dail Eireann, Debates, 1st July 2010, 438