We will proceed to consideration of section 6 and amendment No. 34 in the name of Deputy Yates. Amendments Nos. 35 and 36 are alternatives while amendments Nos. 37 and 43 are related. Have I your agreement to proceed to consideration of amendments Nos. 34, 35, 36, 37 and 43? Agreed.
I move amendment No. 34:
In page 7, subsection (1), lines 40 to 42, to delete "as soon as may be after the commencement of this Part and thereafter as occasion requires or as may be directed by the Minister" and substitute "within 12 months of the commencement of this Part and annually thereafter".
Amendment No. 34 is very similar to amendments Nos. 35 and 36. This is a basic question of accountability. It is envisaged in the original section 6 that the health boards would publish reports in relation to their work and plans for child care and family support services in their jurisdiction. It is important that we give a clear message to health boards that we expect the maximum level of accountability. Knowing the way health boards provide an annual report of their overall level of activities, it is only reasonable that the child care services fit into that same level of accountability. What I am proposing, therefore, is that within a year of the commencement of this Act, an annual report would be prepared and that one be prepared each year thereafter. This does not place an excessive onus on health boards. It fits into their overall position. I have not studied in detail the wording of amendment No. 35 but I see it is basically the same — within 12 months of the commencement. I would think that this is just improving section 6. It does not take away from the intention to do this but it puts a clear obligation on health boards to do this. In the name of accountability I think it should meet with the general support of the committee.
Amendment No. 35 reads:
In page 7, subsection (1), lines 40 to 43, to delete all words from and including "as soon as may be" down to the end of the subsection and substitute "within 12 months of the commencement of this Part and thereafter at least annually, have a report prepared and published on the adequacy of the child care and family support services in its area".
This is quite a good section. The provisions in section 6 are quite good but the great weakness is where health boards are required to carry out periodic reviews of the adequacy of the child care services in the area. We must realise that in enacting this legislation a tremendous responsibility will be imposed on health boards. Let us remember that child care and child abuse is becoming a serious problem, hence the need for this Bill. The question that arises therefore is whether it is too vague to say that the periodic review should be carried out or whether it should be more specific.
My amendment No. 36 is on parallel lines. The reasons given already would support the idea that there should be an annual report not only so that there would be a requirement for people to focus in on an annual basis to be programmed into the work of the health board, but that they would know annually that they would have to produce this report rather than as occasion requires which would mean all things to all men. Some health boards would find that the occasion did not require it for many years. It is important to have a national standard. The notion of some health boards making an annual report and some making a bi-annual report is unacceptable. There should be a national standard and national co-ordination in this regard. It is perfectly acceptable and reasonable to require them to report on an annual basis.
In regard to my amendment No. 37 the position is that our system of Government is based more on concealing information than revealing information as regards certain reports.
May we adjourn for five minutes?
We are discussing five amendments. It is my intention that the first reports to be provided under section 6 will be completed within 12 months from the coming into operation of this Part. Therefore, I have no dispute with the Deputies on that point. However, I do not accept the view that subsequent reports should be carried out on an annual basis. I would point out that in some of the smaller health boards the level of child care activity is, and is likely to remain, small, so requiring a report every year seems excessive. Furthermore, stipulating that the reports shall be provided annually might prevent the Minister for Health seeking reports more frequently if this was required from time to time in the event of a specific issue which was giving rise to public concern.
With regard to laying reports before the Oireachtas, I would like to remind Deputies that the purpose of these reports is to ensure that each health board carries out a regular review of the adequacy of the child care and family support services in its area. As such the reports are an administrative tool to assist health board management to identify gaps in services, prepare plans for improvements and ensure that the best service possible is available for the children in its area. By proposing that the reports be laid before the Oireachtas, Deputies are attempting to shift the debate, and perhaps also the decision-making, away from the local health board level where it should take place, at least in the first instance, to the national level. I do not think this is helpful, appropriate or ultimately beneficial to the provision of the best local services. I might point out that the Housing Act, 1988, contains a similar provision requiring local authorities to carry out regular assessments of housing needs in their areas. There is no requirement that these housing assessments be laid before the Oireachtas.
I will have a look at that later. I do not believe that there should be such a requirement here in relation to these reports. With regard to amendment No. 43 I do not think it is helpful to link the question of research — which is what section 9 deals with — with the notion of annual assessments of services. First, I would have to point out that our services are being continually assessed both at health board and Department of Health level. Furthermore, it would be unhelpful to combine research with annual assessments. It is well known that a lot of research takes much more than one or even two years to complete.
I welcome the Minister's acceptance that the first report would be within 12 months. That is a reasonable expectation and a reasonable imposition to put on health boards but I am surprised that he did not follow through the logic and accept that reports be prepared on an annual basis by each health board. I do not think any health board is so small that it would not have anything to report on a 12 monthly basis. The principle is important because it focuses on the necessity to monitor the situation so that a public report will be available on a 12 monthly basis. The fact that this might be a short report is neither here nor there. There can be a report of three or four pages if that is all that is required to encompass the activities of the child care work in the health board region and the work of this Bill once it is enacted into legislation. The principle is fundamental and I do not think the Minister should be distracted from it by virtue of the fact that it might not be a very sizeable report in some instances. The principle that the report should be submitted is an important one.
In relation to laying the report before the Oireachtas, the Minister is correct in saying that the first responsibility of the advisory committee obviously is to the health board proper and it is proper that they debate it in the first instance. I would not quibble with the fact that there would be a requirement to place it before the Houses of the Oireachtas because a huge volume of information is laid before the Houses of the Oireachtas that most of us never have the opportunity and the time to address.
It is proper that the health board would look at the reports and act upon any recommendations made therein. It is important that there would be a statutory obligation that health boards would report on an annual basis. I have no doubt that some will do it anyway. It is a red herring for the Minister to suggest that putting in the requirement for an annual report would in any way preclude the Minister's right to have a more frequent report. I am sure if he requests information on any person from the health board he will get it expeditiously.
I hope the Minister will accept the notion of the annual report so that clear signals and clear markers will be given to health boards of this requirement, regardless of the volume or dimensions of the report, and also to get back to the fundamental point of having a comprehensiveness about the legislation that would be implemented on the same basis in every health board region throughout the country.
I am a little confused as to the exact purpose of the report. The report is, according to the section, to allow a health board to review services and how they are operating. The report is a report that apparently has to be submitted to the Minister. As I see it, the Oireachtas has a role as the national Parliament to have available to it information to assess the manner in which our child care services are functioning and where there are problems with our child care services either nationally or locally, I think Members of the Oireachtas, and indeed the general public are entitled to that information. Perhaps the Minister would clarify whether these are to be secret reports. Are they reports to which the general public will not have access? Are they reports that Members of the Oireachtas will not have access to? That is a very real problem.
We will not know if this Bill is working properly when it becomes operative. We will not know whether the health boards are fulfilling their functions under this legislation. We will not know whether the legislation is adequate or needs to be amended in some ways, if we do not, as Members of the Oireachtas, have access to information to give us an overview as to how each of the health boards are functioning. Over the years, since I have been in this House, I have tabled a variety of Dáil questions looking for statistical and other information about the workings of our child care services. In my early years in the House I found that much of the information I was looking for was simply not available and I was told it would be inordinately expensive to gather up the information.
One of the reasons our child care services were in poor condition and were not meeting many of the needs was simply because no one seemed to have the information necessary to take on overview. I believe, as a result of Dáil questions tabled in the 1981-82 period, various statistical information has started to be collated by health boards and some of that information is now coming through in Dáil questions.
As I see it, this Bill should perform a function in ensuring that Members of the Oireactas get an overview as to how the health boards are working. There is no point in a secret report being prepared to be submitted to the Minister. I think the Minister should clarify what his intentions are in this area. I do not understand why any assessment of how the health boards are carrying out their functions should be kept secret. There is the question of accountability and also the question of ministerial accountability. I accept locally there is accountability to the health board itself but nationally this Parliament is entitled to know what is happening. As matters operate currently, we are frequently told that the only way to get information is not by tabling Dáil questions but by writing individually to health boards, who very frequently will not supply it.
This is a very important matter. It is not a question of taking a party political view but of ensuring that we have a coherent and comprehensive overview in the future as to how the health boards are functioning. It seems to me quite reasonable. Most State organisations have to account for themselves annually in annual reports. I do not see anything unduly onerous in imposing an obligation on a health board to produce an annual report as to how their child care services are operating and whether there are gaps and problems. I accept that a health board highlighting gaps due to lack of resources may embarrass this Government, or indeed a future Government of a different political persuasion, where resources have not been provided, but that is not a reason for keeping reports secret. The Minister might clarify that. It might be the intention that these reports will go to the health board and become public information through the health board and if that is the case, well and good, but it does not seem to me that that is what is provided in the legislation.
First, I welcome the Minister's acceptance for reporting within 12 months. I would just point out that my own amendment differs slightly in that it says "thereafter at least annually." That may be a compromise. I certainly think that the reports should be laid before both Houses of the Oireachtas. This is vitally important because it will show what the trends and developments are at a particular time. It is very important that that be done.
I agree with what has been said, particularly as we have already noted — I am sure the Minister and the Department of Health will be the first to agree with us — that what we lack most in this country are statistics and a data base for regional and national use. First, we must recognise and acknowledge difficulties and also the fact that we have not got national registers. Thankfully, we are entering a phase where that kind of information would not alone be of tremendous interest to legislators in the area of children and children's rights but also would be invaluable in setting up such registers and a data base and working on co-ordinating and centralising the information. As well as that, it could be of tremendous support to the various health boards themselves in so far as their annual reports could highlight particular difficulties in their regions.
The other thing we are aware of — even from the small amount of information we have — is that there are demographic and geographical differences with regard to problems, abuses and areas that we have not even identified yet. It is of the utmost importance — certainly not taking away from the local autonomy of the health boards themselves — that we, as legislators, would be aware of and would hopefully monitor the situation. We should use it in the most informed and co-ordinated centralised way possible too, to make sure that every region — and there may be differing trends or items peculiar to regions — would be identified and treated and maybe an argument made for resources to be invested above and beyond what the health board had argued for. I really feel it would be a very worth-while initiative.
I was taken aback by the Minister of State's reply. He made a number of presumptions which I really find incredible. First of all, he said that the reason he was not going to have an annual report was because the level of activity in the health board is going to be small. Who is to say that the level of child care service is going to be small? It is interesting to note that the Department in their scripts said it was going to be small. I am very fearful for the resources that will be made available for child care services if the services are going to be so small that they are not going to even deserve an annual mention. To me that has just let the mask slip a little bit more than it should have as regards what they actually intend once this legislation is passed.
Secondly, to suggest that there should not be annual reporting or accountability of any Government service, is really quite remarkable and as a politician I find it is totally unacceptable. The whole system of Government we have is one of annualised accounting, annual estimates, annual budgets. If decisions regarding how public money and taxpayers' money is to be spent on child care services are made without reference to annual accountability for the expenditure of that money, it strikes me as quite extraordinary that they would not be made available to the public and to the Oireachtas. I see no defence whatsoever for saying that we should have reporting less often than once a year.
For the Minister to say that annual reports would in some way interfere with his capacity to get further reports is simply not true because section 6 (1) allows the Minister to have a report whenever he wants and he can have any such report so there is no interference. The Minister may ask for anything he likes any time he wants. Then we have the classic case: the Minister said that by accepting amendment No. 37 in relation to laying the report before the Oireachtas, that in some way we would shift the balance between the health board and the Dáil. First, I do not accept in any way that the laying of any report shifts the balance in terms of executive functions. I make no apology for saying that every arm of State service should be accountable to the Legislature. After all, it is to the Legislature they should be accountable. At the end of the day the politicians are accountable to the people because they can be chucked out at election time. I noticed the Minister was reading from a script which came from the vaults of the Custom House. With respect, this is typical Civil Service stuff.
From the vaults of Hawkins House?
Whatever vaults they came from. The process of concealing basic information from Members of the House should be resisted by Members. If the Minister has the information there is no reason why the House should not have it also. There is no question of shifting the executive balance because the Dáil is not going to be running child care centres or allocating children to foster parents; the Dáil wants the information merely to make assessments.
The Minister's response was absolutely incredible. Every local authority, health board, national building agency and the IDA have to publish an annual report and I do not understand why the child care services should be any different. There is no reason why they should not have to publish an annual report. It is wrong for the Minister to presume that the level of child care service is going to be small in the first instance. Even if it was, as Deputy Howlin said, that would not justify the non-existence of an annual report. I think it is absolutely obligatory that the Dáil should be given the courtesy of having these reports at the earliest possible date, and I believe a month is a reasonable period. I would ask the Minister to look with more scrutiny and cynicism at some of the notes that are handed to him because they certainly undermine the role of politicians.
I can assure the Deputy at the very outset that every note which comes to me is scrutinised in the greatest detail and that before anything is uttered by me it has my personal imprimatur.
We were discussing whether or not we should have annual reports and whether they should be laid before the Houses of the Oireachtas. The intention is that these reports will be produced for the attention and consideration of both the members of the local health board and the Department of Health so that they can see whether the board are carrying out their statutory duties under the Bill. That is the main purpose of the reports. The reports will not be secret. They will be available to the public by virtue of the fact that health board meetings are public bodies and are held in public. Members of the Oireachtas, by way of parliamentary questions to the Minister for Health and in various other ways, would have the opportunity of getting the relevant and necessary information.
Both Deputy Shatter and Deputy Yates seem to be suggesting that the health boards are not co-operative and do not give information. I have to say that I find health boards very open in the information they give.
You are the Minister.
I want to give an example of a health problem that occurred in the West of Ireland. A circular letter on this problem was submitted to all Members of the Oireachtas in 1989 and was duly attended to by many of them. A Member of the Oireachtas from the east who wrote to a health board in the west was able to elicit very relevant information which put a new dimension on the whole problem and led to various and successive meetings which culminated in the matter being resolved to everybody's satisfaction.
The quality of east coast Deputies.
I do not take issue with that matter but I always regard the quality of the west coast Deputies as being much more practical. I gave that example merely to show that an elected Member of the Dáil who was not from the health board area concerned was able to make a submission to a programme manager in that health board and elicit the necessary information which resolved the matter to everybody's satisfaction. If that is not openness and the disclosure of information by a health board I do not know what is. It is a shining example of the co-operation and the information that comes forward to Members of the Oireachtas. I hope Members know that we believe reports should be available when necessary; the Minister for Health should have the right to call for a report at any time; it is a matter for the health board and their child care advisory committee to compile their reports as they require them. The Minister for Health can, if necessary, request a report at his discretion and ultimately Members of the Oireachtas have the right to table questions, put down motions and elicit information as they see fit. I cannot see anything wrong with that proposal.
I agree completely with the strong case made by Deputy Yates in regard to public accountability. With regard to the suggestion made by the Minister, as legislators we are very much aware of the costs involved both in terms of money and the time spent by civil servants in preparing parliamentary questions and I deplore the suggestion that the only way in which information would become available to us as legislators would be through the process of putting down parliamentary questions. I believe it would set a precedent which the public would reject. It would be timely, costly and certainly be a denial of information to all legislators. I take the point Deputy Yates made that we are publicly accountable to our electorate and for the budget and, therefore, the only way in which we can show that kind of public accountability is by way of debate on an annual report which is freely available.
I wonder if we are nit-picking here? If the report is available, is quoted in the newspapers and available to health board members why not lay it before both Houses? We are not talking about an obligatory debate; a motion would have to be put down to do that. If the report was placed in the Library it would facilitate the work of Deputies in the preparation of speeches. They would be able to refer to these reports in the same way as they can refer to the prison visitors reports. However, I would not like to think that the child care reports would be as late in coming as those reports. I do not think it is a very big issue whether the reports are laid before the Houses.
It is not that big an issue for me but it seems to be a big issue for the Opposition. I am considering five amendments and I would like to go some way to meet the Deputies. In view of all that has been said I am prepared to accept amendment No. 36 from Deputy Howlin. If Deputy Yates and Deputy Sherlock are prepared to withdraw amendments Nos. 34 and 35, I will be prepared to concede amendment No. 36. The effect of amendment No. 36 would be that the health board would be required to produce a report annually or as may be directed by the Minister. Amendments Nos. 34 and 35 propose to delete the reference to the Minister so that the Minister would not be able to seek reports more frequently in the case of an issue of major public concern. The advice available to me is that if we were to accept this proposal it would create difficulties for the Minister. Consequently, I regret I cannot accept these amendments. If the other amendments are withdrawn I will be prepared to concede amendment No. 36.
I am happy to withdraw amendment No. 34 on that basis. The Minister has said the first report will be published within 12 months and that is what is proposed in amendments Nos. 34, 35 and 36. However, I believe amendment No. 37 is still valid. I have not referred to amendment No. 43 at all because I honestly believe research is a separate issue and I would rather confine my comments to section 9 when we get to it. That amendment is not going to be voted on now anyway.
I move amendment No. 36:
In page 7, subsection (1), line 41, to delete "as occasion requires" and substitute "annually".
I move amendment No. 37:
In page 7, between lines 43 and 44, to insert the following subsection:
"(2) The Minister shall lay all reports received under subsection (1) before both Houses of the Oireachtas within four weeks of their receipt.".
I thought I had made my position on this amendment quite clear. First it is unnecessary because the reports will clearly be by the child care advisory committees for the relevant health board; the copies will go to the Department of Health and the Minister for Health as a Member of the Dáil will be responsible to the Dáil. It will be an unnecessary imposition to have these reports produced and sent to the Houses of the Oireachtas every year. I have gone a long way towards accepting that a report should be made annually or as directed. I hope, in that spirit, we can dispose of these other two amendments.
I do not want to debate this any further but I will be pressing it. It is an important issue. Amendment No. 43 will not be taken now either way.
- Barnes, Monica.
- Sherlock, Joe.
- Fennell, Nuala.
- Yates, Ivan.
- Howlin, Brendan.
- Ahern, Dermot.
- Fitzpatrick, Dermot.
- Coughlan, Mary.
- Jacob, Joe.
- Dempsey, Noel.
- Treacy, Noel.
Let me ask one question on subsection (2) (d) which reads:
Without prejudice to the generality of subsection (1), a health board in preparing a report under this section shall have regard to the needs of . . .. children whose parents are unable to care for them due to ill-health or for any other reason.
It is, obviously, important that they would take account of the needs of children whose parents are unable to care for them, but I wonder why the reference to "ill-health" has been put in. I know from my own investigations that ill health is not a significant factor in parents being unable to care for their children. Why was it necessary to put that particular reason in? It is something that caught my eye. Why not just state "children whose parents are unable to care for them"?
I presume the Deputy is referring to section 6 (2). Is that correct?
Section 6 (2) (d).
Subsection (2) requires health boards to have regard to the needs of certain categories of deprived and disadvantaged children in its preparation of reports. The idea is to ensure that there would be statistical data and the maximum information available to the health boards and the Department of Health so that conclusions could be based on the information in any particular situation. Because of the complex difficulties that may arise we must ensure that that information would be available to the health boards and the Department so that they would have the best information available to arrive at conclusions and to make proper decisions.
I fully understand what the Minister is saying. I wonder why the reference to "ill-health" was put in as one could list another dozen. Why was that particular clause inserted? Is there statistical evidence to support the feeling that that is a significant factor in parents not being able to care for their children? It is something I am not aware of and the agencies I have been in contact with were not aware of it either. I wonder if it is a significant factor.
It is a significant factor. The reason it has been included is that a small percentage of cases involve families where the parents have psychiatric problems or are mentally deficient. We want to have the facts available.
Looking through my notes I see that some of the amendments I had intended putting down have not been tabled. There has obviously been some mix up in my office. I ask the Minister to explain why, in relation to section 6 (2) — which refers to children who will be referred to in the report, such as children whose parents are dead or missing — there is no reference to children who are in the care of the health board. Surely it would be appropriate to include them. Secondly, I would again ask the Minister — and here I am looking at additional subparagraph (e) in my original notes — to consider bringing something forward on Report Stage.
I feel something could be added along the lines of paragraph (e) "children who are in the care of a health board" and (f) "children with mental handicap". I raised this point this morning but I feel that children with mental handicap are worthy of a mention at least in a report on services. It would be valid to include both. I ask the Minister to consider that suggestion before Report Stage.
Let me reply to the points raised by Deputy Yates. The list included here is not an exhaustive one by any means. We felt that these are the minimum guidelines that should be laid down. I will definitely consider what the Deputy has suggested before Report Stage. It is important that we cover all the categories, if at all possible.
Amendment No. 38 in the names of Deputies Yates and Sherlock. Amendments Nos. 39 and 41 are related. Have I the agreement of the committee to take amendments Nos. 38, 39 and 41 together?
Would the Minister comment on amendment No. 41?
Basically, I would need to take Nos. 39 and 41 together, as they are consequential.
Is that agreed? Agreed.
I move amendment No. 38:
In page 8, subsection (1), line 13, to delete "may" and substitute "shall".
Section 7 refers to the relationship between the health boards and voluntary bodies. There are many different voluntary organisations that provide health care services: mental handicap and child care services would be good examples. I know it is a matter of concern for both the voluntary bodies and the health board administrators and officials, that often these arrangements are very loose. They have often sprung up over a period of time and are almost traditional. Because the voluntary service was there before the statutory service there was no point in the health board duplicating the service by providing an alternative service. However, it appears that the health boards have different priorities to the voluntary bodies and we should move towards providing contracts of service. Let me quote one example of the type of difficulty we can run into. In the Dáil recently the Minister berated the Cheeverstown Centre for the Mentally Handicapped, a voluntary body which has different priorities to those of the health board.
When we talk about the relationship between voluntary bodies and health boards we should be as precise as possible. What I am seeking to do is to insert the word "shall" instead of "may" so that where arrangements are entered into with voluntary organisations there will be a contract of service and there will be lessad hoc development. It leads to misunderstandings and suspicions on behalf of the voluntary body that the health board have ulterior motives and so on. The other point about using the word “shall” is that it would ensure some level of protection for voluntary bodies who are already providing services for health boards and that there would be some continuity of those services after this legislation is passed. All of this legislation gives new powers to health boards and it is important to safeguard some of the voluntary work that is being done already so that the health boards could not say, “now that we are operating under a new Act we may or may not deal with you anymore and we are going to cut you out of our operations”. For both of those reasons the word “shall” should be used instead of the word “may” and I would assert that this very important area has been loosely legislated for all too often in the past.
This section recognises the importance of services provided by the voluntary sectors and organisations. That recognition in itself is welcome. I want to tease out from the Minister exactly what is his intention in this regard in relation to the way the section is worded and including the use of the word "shall" other than "may". The health boards, obviously, will retain the power and, indeed, the statutory duty to provide for children but will they have the legal authority to devolve this duty, devolve this responsibility that is statutorily imposed on them to a voluntary organisation subject to negotiation? The voluntary agency then would, obviously, be accountable after negotiation to the health board in question. In other words, what I am asking the Minister is, will he explain in detail the relationship he would envisage existing between the voluntary organisations who often supply a service on the ground and the health boards who, after the enactment of this legislation, will have a statutory responsibility to provide that service. Will it be within the ambit of the health boards to devolve that authority latterly to another agency and what will be the level of accountability and the relationship between the two? If that was explained by the Minister it would help us formulate our view in relation to the amendments that we are considering now.
This is a drafting matter more than anything else. I have grave difficulty with inserting the word "shall" for "may" in section 7 because it makes it obligatory on the health boards to divest or devolve that authority down to voluntary organisations — all voluntary organisations it would appear — who would demand it. In fact, there is an onus on the health boards to give them this right to provide family support services and so on. In effect, health boards would be divesting themselves of all their interest in this area. I cannot see how the word "shall" could be inserted.
I should like to respond to Deputy Howlin first. Section 7 is one of the most important sections in the Bill. It provides that in carrying out their functions under the Bill in relation to the provision of child care and family support services, health boards may enter into arrangements with voluntary bodies and other persons. This enables health boards to make arrangements with religious communities, voluntary organisations etc. to provide child care and family support services on their behalf. Subsection (1) would allow health boards to enter into arrangements, either contractual or informal, with voluntary bodies to have child care and family support services provided by those bodies on their behalf. The Minister for Health may impose conditions governing such arrangements. For example, that rates of pay for staff of voluntary bodies funded by health boards should not exceed those approved for similar grades of staff employed by the health boards or otherwise. Subsection (2) prevents a health board delegating to a voluntary body or other third party their duty to receive children into care under section 4 or their power to institute care proceedings under section 14. These functions are so important that they should only be performed by health boards themselves. However, the health boards would be able to avail of the services of voluntary bodies in caring for those children on a day to day basis, for example, in residential homes or in other places. I hope I have given some information to the Deputy.
As regards amendment No. 38, it would not make any sense to require, as distinct from enabling, health boards to enter into these arrangements. For example, there might not be a voluntary body available in the area or the voluntary bodies might not wish to get involved in formal arrangements with the health board. Furthermore, there might not be a voluntary body with the necessary expertise or staff to take on certain functions on behalf of the health board. In all the circumstances I do not believe that this is a realistic or workable proposal and I regret, therefore, that I cannot accept it. I would like to move to amendment No. 39.
We can discuss it but it will be moved later.
I will discuss amendment No. 39 and in doing so respond to the request of my colleagues. The voluntary input has long been a feature of all our social services. Indeed, many of our services were pioneered by voluntary bodies who continued to make an important contribution to the overall provision of services. As the section is currently drafted a health board may enter into arrangements with a voluntary body for the provision on their behalf of child care and family support services in accordance "with such conditions, if any, as may be specified by the Minister". I have been looking at this again and have decided that it should be amended to avoid any suggestion that each and every arrangement between health boards and voluntary bodies would be subject to ministerial control. That was never the intention. The amendment makes it clear that health boards will be free to make arrangements with voluntary bodies subject only to any general directions that might be given by the Minister for Health from time to time.
As regards amendment No. 41, this proposes a similar change in section 8. That section enables a health board to provide financial or other forms of assistance to voluntary bodies providing child care or family support services in their area. As the section is currently drafted it could be argued that each grant, or other offer of assistance by a health board, would be subject to ministerial approval. Such an arrangement would be totally unworkable and would leave no discretion whatever with the local health boards. I have decided, therefore, to bring forward this amendment which allows health boards maximum discretion in this area subject again only to any general directions that might be given by the Minister for Health. I am sure that the committee will agree that this is a far more satisfactory and workmanlike arrangement and I hope these amendments can be accepted.
In relation to my amendment, No. 38, I am happy to withdraw it. In relation to what the Minister is suggesting, I am inclined to disagree. I made reference earlier to the type of difficulties one can get into in terms of a conflict between what may develop between voluntary organisations, centres, be they residential or otherwise, and a health board. Any Member who was present for what the Minister had to say in the Dáil about Cheeverstown will know exactly what I am talking about. We had public vitriol poured by both sides and that was most unhelpful for everybody. Therefore, what the Minister originally had in the section, that any conditions and any agreement between the health board would be specified by the Minister or that the consent of the Minister would be required, may be more desirable than any general directions. The only case against having ministerial consent is that the Minister would have a different view from the health boards, which is most unlikely. Therefore, it is important that there is the minimum level of what I call "ad hocery" at local level. Often what we have is a senior executive entering into an arrangement and when that person retires someone else inherits that arrangement. We can get into the most bizarre situations. We should have the maximum level of uniformity about such contracts of service. There should be the maximum level of definition of what is the role of the particular services to be provided and subsequent maximum level of accountability. This goes very much to the root of a lot of the problems being experienced with the health service — that money is given to public voluntary hospitals and it is not defined exactly how such allocations were calculated. It appears to the based on what they got last year. In addition, no precise role is defined for the hospital. That is just one example.
I would be slow to minimise the role of the Minister but in considering his role I would ask the Minister: what is the difference; what is a general direction as opposed to what was originally contained in the Bill? Does "general" mean that the Minister would lay down terms of contract as regards definition and accountability or does it not mean that? It is wrong to assume that it would be excessively bureaucratic for the Minister to have this power because, invariably, the relevant health board and Department would just give the nod to whatever was agreed. Alternatively, it would give the Minister the power to intervene when things go wrong, as has happened in Cheeverstown.
I am surprised at Deputy Yates finding fault with this amendment because in my opinion it places a greater onus on the health board. Anyone involved in public life will know that if a statutory local body has to obtain the consent of the Minister such application is submitted to the Department and gets lost there for a considerable time as it is dealt with within the various sections of that Department which could delay an arrangement being made with a voluntary organisation. In accordance with the two amendments being proposed by the Minister I would envisage him outlining general guidelines each health board would follow rather than each health board having to write to the Minister in each individual case seeking his consent, when such application would tend to get bogged down in bureaucracy for a couple of months. I contend that the Minister's amendments are entirely acceptable.
For a change, I am in agreement with the Minister. The proposition he has put forward and the logic behind it is perfectly acceptable. It is important to have a reasonable degree of flexibility on the ground particularly in an area in which one cannot envisage every local circumstance. It is important that the health boards — if we are to have any faith at all in them — should have the flexibility to make domestic arrangements with a reasonable degree of monitoring from on high but without the type of rigidity that would necessitate ministerial imprimatur. I have no difficulty in accepting the amendments put forward by the Minister. They are quite reasonable and will improve this important section because of the importance of the voluntary sector in the whole area of child care which we all fully recognise.
On a point of information — and it may be that legislative language differs from lay person's language — my worry there would be in regard to the term "subject to general directions given by". "General" in everyday language means very vague, nebulous. What would worry me — which is the point made by Deputy Yates — is that somebody could pin their case on the fact that they were generally following the directions of the Minister. Would that leave it too open and flexible for control or discipline? Perhaps some autocrat would contend that he or she was generally following ministerial directions. Perhaps the Minister's language means something different when it is contained in a Bill — but I am somewhat worried about it.
I have listened with interest to what has been said. Perhaps we are splitting technicalities. To give the committee a few examples: health boards throughout the country pay individual grants to about 300 crï¿½ches. We do not want circumstances to obtain in which every one of those applications must be submitted for ministerial sanction before payment. That would be a waste of time and money and would restrict the bodies providing these services, placing them in a financial straitjacket because decisions could not be taken locally — devolved functions, utilising local regional systems leading to quick decisions. There are dozens of bodies with whom each health board deals, reputable bodies with a great liaison with the health boards, each having confidence in the other, doing a good job in the common interest of delivering the best health services possible in their areas. Where that system is working properly we do not see any need for Ministerial sanction. Where the system is working well, the health boards having the competence and the bodies being reputable we believe such decisions should be taken locally.
Deputy Barnes posed a question about the terminology. On the technical side, I have outlined the bodies, the organisations and the decisions to be taken. What we are saying is that the Minister could lay down guidelines which would mandate the health boards and the child care advisory committees in decisions they take. He could lay down the relevant criteria to be complied with when a body is applying for a grant to the effect that they can qualify only based on say, (a), (b), (c), (d) and (e), or whatever are the criteria laid down. Once the bodies applying for the grants qualify within those stipulated guidelines, then the local health board and advisory committees have discretion to take their decision, recommend and make subsequent payment based on these criteria. For example, the Minister could lay down criteria on hygiene standards, the quality of housing, the environment, which should be maintained for children in residential homes and so on. Individual, technical cases should not have to be subject to ministerial sanction, thereby leading to more flexbility within the system and quicker decisions being taken.
I take the Minister's point in relation to the processing of each application. Perhaps the best way to meet the point I was making would be that, as part of the general directions, the Department reserve some rights to themselves — to allow the Minister and the Department to get involved where things go wrong, so that consent would not be required in each case. I am mindful of many different experiences when what worked out as a harmonious relationship subsequently developed into a situation employing a lot of people, providing services when there was a direct conflict of opinion as to how those services should develop between the health board and the voluntary organisation. It is very messy. I am not opposed to a general approach as outlined by the Minister but I think it should allow for the contingency where, for example, the health board and the voluntary organisation or agency fall out with each other.
The Minister for Health — with a statutory function representing the Oireachtas in discharge of his duties in the health area — has the right at any time to intervene in any matter within any health board if he feels it to be necessary. Under the proposals contained in amendments Nos. 39 and 41, the Minister will have the right to give general directions or, indeed, to intervene in any situation but we do not want to impose a ministerial diktat on every decision being made.
I move amendment No. 39:
In page 8, subsection (1), lines 13 and 14, to delete "in accordance with such conditions, if any, as may be specified by the Minister" and substitute "subject to any general directions given by the Minister and on such terms or conditions as it sees fit".
Does Deputy Yates wish to move amendment No. 40 or would he prefer that consideration be deferred?
I would prefer that it be considered next week.
Before we adjourn can we agree a time and date of our next meeting?
Shall we agree to meet on Wednesday, 24 January at 11.30 a.m. and sit all day until approximately 5 p.m.? Agreed.