Special Committee Child Care Bill, 1988 díospóireacht -
Wednesday, 24 Jan 1990

SECTION 7.

Mr. Yates

I move amendment No. 40:

In page 8, subsection (2), line 20, after "other person" to insert "other than an agency approved by Ministerial regulation.".

The purpose of this amendment is to widen the scope of this section in terms of the maximum possible number of persons or organisations who may be taken on by a voluntary body on a professional basis to do work. This is a somewhat technical amendment which proposes that no group who might be found suitable by a health board to carry out work would be excluded.

Minister of State at the Department of Health (Mr. N. Treacy)

Section 7 (2) prevents a health board delegating to a voluntary body or other person their duty to receive children into care under section 4 or their power to institute care proceedings under section 14. The thinking here is that these functions are so important that they should only be performed by health boards as the statutory authorities responsible for child care and protection. This amendment seeks to enable these functions to be delegated to an agency approved by the Minister. I do not see any justification for the proposed change. In the first place I am not aware of any agency who would have the necessary staff, expertise or access to foster care and residential facilities that would be required if they were to take on this role.

In any event I do not think it would be a good idea, now that we are imposing clear statutory duties on health boards in relation to the care and protection of children, to hive off to other agencies some of the key functions in relation to child care and protection. This would only give rise to enormous confusion and duplication as to the respective responsibilities of the health boards and any agency who might take on this role. One common theme that has come out clearly from the various child abuse inquiries that have taken place in Britain in recent years is the need for co-ordination and consistency of approach in relation to child care and child abuse in particular. I think this can best be achieved by placing these statutory responsibilities firmly on the health boards rather than dispersing them far and wide. For these reasons I am not prepared to accept this amendment.

Mr. Yates

I do not intend to press the amendment.

Amendment, by leave, withdrawn.

Section 7, as amended, agreed to.

SECTION 8.

Mr. N. Treacy

I move amendment No. 41:

In page 8, subsection (1), line 24, to delete "with the consent of the Minister" and substitute "subject to any general directions given by the Minister".

Members may recall that this amendment was discussed at our last meeting when we considered a similar amendment No. 39 to section 7, which was agreed to. This section enables a health board to provide financial or other forms of assistance to voluntary bodies who are providing child care or family support services in their areas. 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. For example, as I mentioned on the last occasion there are some 300 pre-schools and cr�ches in receipt of financial assistance and it would be ludicrous if each and every grant was to be subject to ministerial approval, as could be inferred from the present draft of the section. The amendment will enable a health board to provide grants or other forms of assistance subject only to any general directions that might be given by the Minister.

Mr. Yates

Earlier we questioned whether general directions were adequate — I think it came out in our discussion that these general directions were not drafted as yet — and I have certain comments to make as to why they should be more specific. Are we taking amendments Nos. 41 and 42 together?

Chairman

They are being taken separately.

Mr. Yates

All right, I will withhold my comments on this point until later. However, I believe health boards could have different modus operandi simply because the directions given to them were too vague. There is experience in other aspects of health board work to show that there are wide variations between health boards. In agreeing to amendment No. 41 in the name of the Minister I have to say there is an obligation on him to make the directions as specific, as opposed to as general, as possible.

Mr. N. Treacy

We agreed earlier that the health boards will have to produce an annual report or at times the Department or Minister think appropriate, so I think they will have to be fairly uniform in the circumstances. We hope the modus operandi will be fairly consistent.

Amendment agreed to.

Mr. Yates

I move amendment No. 42:

In page 8, between lines 32 and 33, to insert the following subsection:

"(2) Payments provided for under this section shall be paid on the basis of fixed terms of renewable contracts with a defined level of service as laid down by the Minister.".

This amendment seeks to ensure that the agencies or persons carrying out work for health boards do so on a contract basis. I think, legally, this is desirable given the problems that can arise in terms of control and so on. I know of a number of cases where problems have arisen and I would again instance the area of mental handicap where a lot of work in the name of the health boards is carried out by voluntary agencies. Those voluntary organisations and organisations working in the child care area have complained to me that it is not specific enough and health boards aften tack on additional duties that were not properly budgeted for at the beginning of a year and make requests. Organisations such as the ISPCC desire standard contracts of work to be carried out in an organised fashion rather than in an ad hoc fashion as has been the case to date. We must provide a legal basis for these. There is also the question of accountability. The taxpayer should know exactly what return they are getting for their money.

Mr. N. Treacy

I have a number of difficulties with this amendment. In the first place, I would point out that section 8 enables a health board to make a once-off grant or a periodic contribution towards the expenses incurred by a voluntary body providing child care or family support services. In the case of such once-off or periodic payments, the question of renewable contracts does not arise. The health board must have the discretion to pay a once-off grant without being tied into a renewable contract.

While I can see that in certain cases, for example, the provision of ongoing residential services, it would be good practice to have a contract between the board and the voluntary body, in other cases it would not be appropriate, for example, in the case of a small once-off grant to set up a toy library. I also have doubts about the suggestion that the proposed contracts be based on a defined level of service laid down by the Minister. I do not believe it would be practicable to create a situation in which every contract which a health board wished to make would have to be vetted by the Minister. However, it seems that this would be the effect of the amendment.

Under section 3 health boards are placed under a statutory obligation to provide child care and family support services. It is a matter for each board to decide on the type and level of services required in its area having regard to the particular needs of the area. While the Minister will have powers under section 52 to give general directions to health boards in relation to the performance of their functions, I do not think it would be desirable that the Minister should take to himself the right to dictate to the boards in specific detail the types and levels of services that should be provided. In view of what I have said, I would respectfully suggest that the Deputy might consider withdrawing this amendment.

Mrs. Fennell

I support this amendment and I think there is a need for this kind of approach. Anybody who has worked with a voluntary organisation, particularly a voluntary organisation providing a social service in the community which many people think should be provided by the health boards or an official organisation, will understand their desire to plan their future and to know if they are still going to be in existence next year. This section enables the health boards to make a once-off grant or periodic payment. I would like to see this amendment included because I think to be fair to those organisations who are going to be brought in under the umbrella of this Bill we need to make the whole thing work. It is not good enough that voluntary organisations only receive a once-off payment. Too many of them at the present time are working on that basis. I think there is a need for this kind of thinking and this kind of approach.

Mr. D. Ahern

I think it would be wrong for us to try to legislate in the contractual area. I do not know of any similar provision in other legislation which places on onus on a State body to give renewable contracts to voluntary organisations. While I appreciate there may be difficulties in some areas, it should be emphasised that this would tie down a health board, particularly in relation to once-off payments and could lead to further difficulties. I agree entirely with the Minister's stance on this. It should not go out from this meeting that the Department are trying to make life difficult for voluntary organisations. That is not the case. It is up to each individual health board to organise their relationship with a voluntary organisation. Similarly, it is up to the voluntary organisation, before they agree to take on work, to decide and to agree and then have that put down in writing in a contract, if they so wish. It would be wrong for us to stipulate that a contract would have to be entered into in every particular case.

Mr. Yates

I accept the point that there should not be an obligation on a health board to renew a contract and perhaps the drafting could be improved in that context. I also accept in the case of a grant for a toy library, for instance, as the Minister quoted, it would not be right to put an inflexible straitjacket on either the organisation or the health board. However, there are other instances where it would be desirable to do so. It is possible that conflicts, in terms of professional appraisal of the work of a voluntary organisation, jealousies between workers on the ground, between health board and voluntary organisation workers, and other problems relating to human nature will arise. It would be good practice to put in place, where voluntary bodies are utilised, some form of contract if desired by both parties. We would very quickly find it is only reasonable to have contracts for the type of work voluntary organisations are seeking contracts for, and a proper assessment of performance can be made on foot of that. Perhaps I would consider withdrawing this amendment on the basis that the wording in relation to renewable contracts is faulty. In return, I ask the Minister to consider before Report Stage — this Bill might be quite lengthy by the time we come to Report Stage — asking health boards if they see merit in utilising contracts of service in cases involving substantial payments and where substantial work is being carried out in the name of the health board.

Mr. N. Treacy

I agree it might be desirable in certain cases for a contract to be drawn up between a health board and a voluntary body. In the residential care area, for example, provision has been made in section 28 (2) (b) to provide for the drawing up of contracts between health boards and the providers of residential care. To return to section 8, there is no bar on a health board entering into a contract with a voluntary body. What I cannot accept is Deputy Yates' proposal that there must be contracts and that these must be renewable. The health board must have discretion in the allocation of grants.

Renewable contracts are always a very delicate matter both financially and legally in any aspect of activity or service. Many voluntary organisations come forward with very meritorious proposals and the flexibility must be left to the relevant health board to decide to make a once-off grant or not. If it makes this once-off grant it should not be mandatory on the particular board to have to renew that grant and continue to pay it. If this was the situation, the voluntary organisation would become totally State dependent and might as well be part of the health board structure rather than a voluntary body. Furthermore, the financial implications, and the danger that other services which may need to be funded, could also be under threat if we were to renew every contract. Consequently, the flexibility must be there. However, in deference to Deputy Yates' wishes, we will consider this again. We will have discussions with the health boards and if we feel we should bring forward something on Report Stage we will do so.

Mr. Sherlock

If we are to encourage voluntary bodies, or other persons, to provide a support service similar or ancillary to the service being provided by the health board, surely there must be some incentive. What is being asked for in the amendment is that that kind of incentive be given. It need not be a renewable contract, a binding agreement, but there must be an incentive. In circumstances where a voluntary body is doing a job there must be a provision so that whatever agreement has been there can be renewed. For that reason I support the amendment.

Mrs. Barnes

I welcome the Minister's decision to give this amendment attention and bring it back, hopefully positively, on Report Stage. Most of us are involved with voluntary organisations on the ground, particularly with community organisations, and we know that one of the biggest difficulties they have is to be able to promise security of continuity. Sometimes they are dealing with very vulnerable groups who need that very confidence. They do not want to be left hanging at the end of one budget year and in danger of going out of business. We take the point absolutely that we cannot get a health board involved in statutory renewable contracts and, as the Minister said have them becoming almost totally State-dependent. On the other hand, there is a very large number of community organisations doing tremendous work, most of it on a voluntary basis, who each year find themselves in crisis of not knowing whether they will survive or not. These organisations deal mostly with groups of people who cannot afford to be in such a critical state. I would like the Minister to take that on board when he is considering the matter.

Mr. M. Higgins

I would like to raise this issue a little more before we move on from it. Listening to the Minister's reply, it seemed to me he addressed the question of the discretion of the board in relation to a renewable contract but the amendment before us speaks in terms of the concept of a fixed term. For example, amendment No. 42, paragraph (2) states:

. . . payments provided for under the section shall be paid on the basis of fixed terms of renewable contract.

The Minister's reply seemed to me to address the issue of contracts running on one year after the other and it seemed to slip away from the concept of there being a fixed term and action within a fixed term. For example, the fixed term, if it is brief and very specifically located, can avoid the implications of renewable contracts. It is simply saying that if a phase of activity is established by way of a fixed term within that one can have the concept of a contract leading on from one year to the other. That is entirely different from saying that one is addressing the issue of whether or not the health board have the discretion to issue contracts that are renewable, annually and so on. Frankly, it requires a further response from the Minister.

Mr. N. Treacy

I have listened with interest to what my colleagues have said. In particular, Deputy Barnes' point is very relevant. This is why we are looking for the flexibility. There are many voluntary organisations who do great work and sometimes they are able to get sufficient cash or have surplus cash and at other times for other reasons they may be short of cash. They may be providing a very relevant and key service in an area. As public representatives we must all accept that were it not for the wonderful voluntary organisations we have, the State could hardly function. No government could provide all the resources, be they financial, physical or whatever, that are necessary to provide the level of service we need. There is an inter-dependence, State support and voluntary effort co-ordinated, to give the best level of service possible. We want this flexibility to ensure that where an organisation is doing a very good job, providing a key service and finds itself in financial difficulty the flexibility would be there for the health boards to make a once-off grant.

On Deputy Higgins' point, we would not have any difficulty with a fixed term contract. That is a very clear situation. There is a fixed term, you would know for exactly how long you would be supporting the organisation. You are giving them an opportunity to strengthen their resources and voluntary organisations can budget on the amount of support available, indicate what support they need to have and ask what they should do after the contract ends. There is no difficulty with that. The difficulty we have is with the renewable contract which makes it mandatory on the State. As members will know, many organisations are set up for a particular purpose. Sometimes we get very good professionals leading those organisations. The reason they are set up at the end of the day is fulfilled but other ideas come on board and there is a demand that the organisation remain in existence on the basis that the support would be mandatory. We must guard against this. We cannot tie the State or the health boards into providing money to a voluntary organisation on a mandatory basis. That would be totally inappropriate.

Chairman

Is amendment No. 42 withdrawn?

Mr. Yates

I note what members of the committee have said. There is a growing view that funding the health service on a year-to-year basis, depending on their annual estimate, is quite unsuitable for a lot of the work of voluntary organisations. When the Minister is consulting with the health boards perhaps they could consider entering into three year contracts of service. I accept that there is a defect in the wording in so far as it would seem to make it obligatory that every grant given would be renewed. The wording can be improved upon but the essential point is that there needs to be clarity where voluntary organisations replace statutory organisations in work and there needs to be incentives in place, as Deputy Sherlock said, to allow them to flourish. The present situation is ad hoc: it varies from one end of the country to the other, it can lead to misunderstandings and different pressures can be put on at different times of the year and there can be great uncertainty. It is an area that has been neglected to date. I will withdraw my amendment on the basis that the Minister will seek to improve upon the area.

Mr. N. Treacy

Thank you very much Deputy; we will have a look at that.

Amendment, by leave, withdrawn.

Section 8, as amended, agreed to.