Radical reform or gradual change? Howlin, Tánaiste clash on how to tackle charity issue
LABOUR leader Brendan Howlin has called for an overhaul of how the entire voluntary health system is regulated but Tánaiste Frances Fitzgerald said it would be excessive and possibly not desirable.
It comes after a series of damning audits this week found that at least 17 senior managers in St John of God’s hospital in Dublin received unauthorised lump sum top-ups in 2013 totalling €1.8million, and how a €40,000 payment to the National Maternity Hospital, Master Rhona Mahony, violated public pay policy.
Following the latest controversies, Mr Howlin said that Section 39 bodies, ‘most of which started out as small-scale charities’ are often now very large operations.
‘Unlike public services, the people working in them do not have guaranteed wage rates or protected terms and conditions of employment, except it seems for some of those who run such bodies. We have had controversy over Section 39 agencies in the past.’
He said the recent internal audits made for alarming reading.
On one audit, he said: ‘There were pay levels in excess of HSE levels, multiple credit cards in use, including credit cards in the names of people who had left the organisation, and high levels of expenditure on meals, bottles of whiskey and jewellery.
‘Ten years after the scandal of the FÁS expenses and having had, since 2014, the scandals relating to the Section 38 and Section 39 agencies, what action will be taken by government?’
Tánaiste Frances Fitzgerald said that ‘it is clear that the Section 38 agencies are bound by public service pay policy. Section 39 agencies are somewhat different.
‘However, the key point about this morning’s reports is that the HSE itself conducted these audits and found these discrepancies.
‘There has been a history with these issues in the past in other agencies.
‘Now the audits in the agencies are being conducted by the HSE, it is finding out these facts and bringing them to public attention and for action by the Government. That is critical.
‘In addition, the new Charities Regulator has been in place in recent years and is doing very effective work.’
She said that there was a mix between the public and private sectors in the health service and that Health Minister Simon Harris was bringing forward actions to begin to address this.
‘Currently, there is a mix of voluntary and public hospitals, as can be seen with the example of Holles Street hospital, and there is also the involvement of the religious in the past. There would be many complex issues in a move to a purely State-run hospital service as we have many voluntary hospitals,’ she said.
But Mr Howlin said that there must be a policy decision now.
‘There will be a long-term process to implement it, covering the lifetimes of many Dáileanna and governments.
‘However, we are delivering public services in an ad hoc manner now, at a cost of billions of euro and through a myriad of agencies. Some of those agencies are service providers because they were charities originally.’
He asked that the Government go further than simply examining the voluntary hospitals and examine all public service provision to see if the State can be responsible for those services, ‘as is the case in most progressive western European countries’.
However, Ms Fitzgerald said this would have ‘widespread implications for the role of the community and voluntary sector in providing services… To suggest moving to a model that is one dimensional would be very extreme.’