Fergus Finlay: The company entrusted with so much has questions to answer

The effectiveness of community services to care for those with intellectual disabilities rely on the trust and finances of society and the State. Picture: File photo

I have to declare an interest. For a lot of her adult life, my daughter has used the services of a company called St John of God Community Services clg. 

My daughter has an intellectual disability (she’s also a legend, by the way), and the company in question is funded by the State to meet her daily needs and her needs in residential care.

I have another interest, because of my involvement with the HSE. But I need to write about this as one of thousands of parents, and also as a citizen. I’m going to try to be as objective as possible, even though a lot of it makes my blood boil. I’ll refer to St John of God Community Services clg as “the company”. It’s named after a catholic saint from the 16th century.

I’ve tried many times to find out exactly how much the State gives the company each year to meet the particular needs of my daughter. So have many other parents. Without success. The company doesn’t know, or can’t say, how much it is funded per person who uses the services.

I do know averages. Roughly speaking, the State gives companies like this about €18,000 a year to provide day services for adults like my daughter, and between €100,000 and €200,000 a year to provide residential services.

The cost of residential services can vary considerably from person to person, depending on the amount of additional support required. Some of the people who live in residential settings need round-the-clock support. 

The vast majority, however, live lives that are largely independent and happy, working alongside company staff who are decent and hard-working and look out for them.

If they live in a premises provided by the company they also pay rent and they pay for utilities and all the weekly shopping. They pay that out of their own incomes. Typically, an adult with an intellectual disability will receive a disability allowance of €203 a week. Rent and utilities (which offset the company’s costs) can take half that.

Some choose not to use the day services provided by the company because they want more fun and interaction in their lives than the company provides. So, out of their tiny incomes, they buy their own day services, by joining clubs or taking courses. The company makes no contribution to these costs — although the average of €18,000 per person per annum the company receives remains intact. You could maybe call it unearned income.

The most recent accounts available (to the end of 2018) haven’t been published by the company on its website — hopefully, they’ll get around to it before the end of the year. But they have been lodged with the Companies Registration Office and the Charities Regulator.

They show that last year, the State gave the company around €155m  in respect of the services it provides to 2,709 people with an intellectual disability. That’s around €57,000 for each person to whom the company provides a service. But only a quarter of the people involved require a residential service. So it’s reasonable to assume that the company is being paid around €150,000 plus a year, on average, for everyone in its residential services.

So it’s a company, a huge and immensely rich company. Its balance sheet doesn’t show it – or perhaps you’d need to be a forensic accountant to figure it out – but it owns property that has to be valued in the millions, if not billions. The company that provides services to people with a disability is itself only part of a larger entity, which among other things runs a highly lucrative private psychiatric hospital set in trees and shrubbery in some of the most valuable real estate in Ireland.

And now it has run into the ground. The company has decided that it is handing back all of its disability services to the State, lock stock and barrel. Well, perhaps not quite that. There is no indication in the statement it has issued that it proposes to hand over any of its profitable services, only the services on which it is losing money.

And I’m guessing it won’t be offering any of its property assets. In fact I’d assume, unless someone tells me to the contrary, that if the State agrees to operate the services – as it will have to, one way or another – the State will be asked to cough up rent for the buildings.

And who’s fault is this? The State’s, of course. The State simply hasn’t given the company enough money, and it can’t go on. Now, the State did increase the allocation by €11m in the course of the year, but the company couldn’t possibly cope with such a miserly increase.

Is that the whole story? I’ve never argued that the Irish State invests enough in disability services – far from it. But if you want the whole truth, a lot needs to be said about how the money that is there is spent and managed.

This is a company that is trusted by people to deliver services they desperately need. It is trusted by the State to manage money well. It is trusted by families who rely on the expertise and care of the staff of the company.

But it is also a company the has failed HIQA inspections into standards in its residential facilities, to the point where several have been threatened with closure and the company has had to commit to massive investment to ensure basic decent standards.

It is a company that over several years made astonishing payments, which it tried to keep secret, to several already highly-paid managers, one of whom sat on the board while it happened. These payments cost the company millions of euro and have never been explained.

When they came to light, the chairman of the company – himself a man of the cloth – wrote to angry and upset families. He assured them that these enormous and secret payments would not result in cuts to essential services. And he also assured them that they – the families and their loved ones – were in his prayers.

And finally, this is a company that as of the date of its last published accounts employs 2,380 people at an average salary of €49,500 each. I don’t have a problem with that – the ones I know are all committed and hardworking and appropriately qualified, and the payroll cost covers shifts and overtime.

But it also has an astonishing 33 employees paid over €100,000 a year, including 11 paid more than €180,000 a year. I don’t know of any organisation in the community and voluntary sector with so top-heavy a management setup.

But what, you’d have to ask, have they been doing? 33 people, paid around €4m a year between them, have managed to run a vital service into the ground. And without blinking an eyelid, they tell us all that the only problem is they weren’t given enough money.

Now those services are going to have to make a fresh start, and lessons will have to be learned. One of them, I venture to suggest, is that more money with no strings attached just mightn’t be the right answer.