Non-profits say HSE coercing them to show break-even status

Barbara O’Connell, CEO, Acquired Brain Injury Ireland, Noreen Ryan, CEO, St. Joseph’s Foundation, Charleville, Mo Flynn, CEO, Rehab Group, Rosemary Keogh, CEO, Irish Wheelchair Association, Bernard O’Regan, CEO, Western Care, and Breda Crehan-Roche, CEO, Ability West. Pic: Maxwell

Some of the largest not-for-profit disability groups claim they are being coerced by the HSE to “present an image of a break-even service” even when they are clearly operating at a deficit.

The claim is outlined in a report commissioned by the Rehab Group, entitled Who Cares, in which eight organisations, including the Irish Wheelchair Association, Enable Ireland, and Acquired Brain Injury Ireland, took part.

The organisations claim this pressure is exerted by the HSE during the annual signing of their service level agreements “on the basis of known, but formally unrecorded, deficits”.

“This clearly presents difficulties for organisations who feel that they are being asked to present an image of a break-even service, while knowing that the opposite is the case,” states the report.

One interviewee quoted in the report said he had to use “very strong language with the HSE, saying ‘You’re asking us to sign something we know is inaccurate and our board are not prepared to do that’.”

In a statement, the HSE said it is “statutorily obliged to ensure that providers are accountable for the services they provide”.

It said concerns regarding organisational financial management and performance forms part of the standard engagement between those providers concerned and the HSE.

The State-funded disability organisations, known as Section 39s, say they are not being resourced by the HSE to deliver the expected level of service and that this is a “key challenge”. 

They say the sector has been underfunded for over a decade, while expected to meet growing levels of compliance and regulation.

The organisations, whose current combined annual funding is circa €430m, say the combined cost of meeting regulation in 2017 amounted to between €500,000 and €1.5m each — with, they say, no additional funding to meet this need.

The groups say the funding gap between what they are getting and what they are expected to deliver is at the point where it is proving a threat to essential services.

The organisations are calling on the Government to fund the full cost of the service and to devise a new model of funding. 

They are also seeking a junior minister for the sector.

Mo Flynn, CEO of Rehab Group, said the sector is “at a crossroads and in crisis”, losing staff at an alarming rate.

“Ultimately, it is the people the sector serves, our most vulnerable members of society, who are suffering in a climate besieged by staff attrition, underfunding and the cost of overly bureaucratic regulation,” said Ms Flynn.

“We are being asked to manage a very significant demand for accountability and compliance, which is welcome, but meeting the requirements of regulation without the funding to meet those demands is pushing us into unsustainability.”

Section 39 organisations are grant-aided by the HSE to provide services mainly in health and social services.

The organisations who took part in the research. launched yesterday, are: Rehab Group, Irish Wheelchair Association, Acquired Brain Injury Ireland, Enable Ireland, Ability West, Western Care Association, Kerry Parents and Friends Association, and St Joseph’s Foundation.

They provide services to some 20,000 people and employ 8,000.

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