Governments must make choices every day, and sometimes they are difficult choices. I have disagreed with many of the choices made by this Government in recent years, particularly on spending. The Taoiseach is well aware that in recent days, 60 organisations providing services to the intellectually disabled are now being forced to either reduce services or to cut them out entirely. This is having an enormous impact on those involved and on their parents, friends and families. It is quite stressful to see the anxiety and distress this has caused. The Taoiseach is aware the unit in Caherdavin in Limerick run by the Brothers of Charity that provides services for 377 people is to close and that two weeks' notice was given to the Daughters of Charity about the closure of the respite centre on the Old Cabra Road.

The Taoiseach is also aware that the best value for money in the health service is given by voluntary organisations, none of which is represented by SIPTU or IMPACT. These people have an enormous output for relatively little money. In the context of priorities and choices that must be made, how is it in a country where there is so much obscene wasting of public money, that this sort of choice is forced on voluntary organisations providing services to the intellectually disabled?

The Taoiseach is also aware of the consequences. How can the Taoiseach justify the reduction of services that are so important to the well-being of thousands of people with intellectual disabilities at a time when there is obscene waste?

The whole purpose of the money that is allocated is to protect frontline services to the greatest extent possible. As the Deputy has said, when I was Minister for Health and Children and Minister for Finance, I was anxious to support the area of disability services and brought forward a five year plan by Government to improve and greatly extend the range of services for people with disabilities, be they sensory, physical or intellectual. More than €1 billion is being spent on intellectual disabilities alone.

There are 178 service providers under sections 38 and 39 of the Health Act. Up to 90% of services are provided by 25 of them. The important point, given that there are limited resources generally, and against a background of increased resources being given to this sector, is that the provision of services in the non-frontline areas ensures there is enough money at the frontline. The Minister of State with responsibility in this area, Deputy Moloney, and the Minister for Health and Children are working to see how we can ensure that for the future. Changes must take place in the support services behind the frontline services. We cannot have 178, or even 25, service providers, even if they provide an excellent service. There must be room for change so we can release resources to the frontline against the background of strict budgetary parameters.

That being said, we must do everything we can to assist the most vulnerable. That is being worked on as a priority by the Minister and the Department. In the context of sustaining services for the future, there must be changes in how organisations cooperate. Why should there be 25 different payroll systems, why should there be a series of different approaches by various organisations? Those all must be pulled together so there are sufficient services at the frontline.

I do not doubt the Taoiseach's personal commitment to this area and I do not disagree that changes must be made. I disagree fundamentally, however, with the fact that no analysis was done of the impact of across the board cutbacks before those changes were implemented.

About whom are we talking? These are children and young people with great difficulties in their personal lives because of the intellectual challenges they face, which leave them needing 24 hour care and attention, ranging from someone trying to understand their gestures to those with metabolic disorders and intellectual disabilities that cause serious behavioural problems. The consequences of the administration minding itself and cuts in frontline voluntary services impact directly on these children and young people and, as a consequence, on their families. I met some of them yesterday. That respite has been taken away, even for four hours once a month, impacts seriously on their lives. That is the consequence of such cutbacks.

When the Taoiseach says he wants to do all he can to help this area, I take the sentiment at face value but what has happened in the Department of Health and Children? What other choices are being made? In the Vote for the Department's budget, the administration budget has gone up by 11% to €42 million this year. That €4 million increase would keep the Daughters of Charity facilities open. The increase includes rises of 67% for office supplies, 104% for consultancy services and almost 600% for value for money reviews. The entertainment budget has been doubled from €100,000 to €200,000, which would keep one of the facilities open for this year.

Deputy Kenny has a tendency to over-run time on Leaders' Questions. Could he ask a question please?

I do not doubt the Taoiseach's personal commitment but this is what has happened under his nose, these are the choices the Government has made, these are the priorities the Government has decided upon and these are the consequences for those children and their families. If the Taoiseach wants to make changes he should at least have looked at what the structure has done; it has protected itself and is demolishing services throughout the country to the detriment of people's quality of life, particularly that of young people affected by intellectual disability. In what circumstances can the Taoiseach justify making choices such as this without examining areas where we could have had serious cutbacks in administration that would keep these levels of services open for those who so need them?

Hear, hear.

They look after themselves.

I would like to give the full picture because sometimes I am afraid that statistics can be used for particular purposes. If one looks at the situation with regard to the increase——

About how many parties——

I have listened to the Deputy's leader with respect and I ask him to step back for a minute——

The Taoiseach without interruption.

——and hear some context and understanding of what is going on.

We know well what is going on.

With regard to the administrative situation, bodies have been subsumed back into the Department. I want to explain this because there is no point in putting out information and then everyone assuming——

Some €22 billion went into NAMA.

——it is just random spending on areas that are not essential. The issue is that there are bodies which needed to be brought back within departmental responsibility and they are being subsumed back into the Department.

More entertainment.

The administrative costs of subsuming them back into the Department are less than the cost of the previous entities when they were separated.

With regard to the question on value for money, if one is spending, as we are, more than €15,000 million of taxpayer money on health services of course one will increase value for money initiatives to see, in a sustainable way against the background in which any Government now has to operate, what savings initiatives can be identified. That work has to be done and it is precisely what is being done in the area of disability services.

There are more than 176 providers of disability services throughout the country; there are probably more than 200 such providers. Section 38 organisations include the Brothers of Charity which obtained approximately €125 million and the Sisters of Charity which obtained approximately €100 million. Section 39 organisations are smaller organisations which receive a grant-in-aid from the Department. There have to be savings in respect of how those services are organised. It is clear we have to do this against the background of less money being available from the taxpayer to deal with these services. We want to make sure that we protect——

What about the children?

——to the greatest extent possible the front line.

Deputy Stanton please.

What about the children?

Deputy Stanton please

If it is the contention that the solution to the problem is simply to increase the allocations against a background where we know more money is not coming into the Exchequer, that will not solve that problem.

Talk about the children. They are not a problem.

I have not suggested they are a problem.

The Taoiseach without interruption.

Facts and figures are rubbish.

Deputy Stanton please. The Taoiseach without interruption

Facts and figures were brought forward by Deputy Stanton's leader.

There are 34 health agencies.

I would put my record in this area against Deputy Stanton any day of the week. I would put my record on this issue against anybody in the House and my record will prove it and has proven it.

The Taoiseach can put his record against many things.

The €22 billion that went into Anglo Irish Bank.

It was the Cinderella part of the services for a long time and there were significant moneys involved. In fairness to those involved in the area, this has often been fully acknowledged and recognised. The point is that we have a problem now and the problem we need to address is how we re-organise the provision of those services to try to maintain sufficient moneys at the frontline——

Get rid of half the managers.

——and a value for money audit is required for that. It is ongoing and will be available to the Minister by August or September.

A question was asked on whether international conferences on health issues will come to this country, which is part of the subhead mentioned with regard to expenses. No Member of the House would stand over non-essential spending in some of these areas but there are——

What about the entertainment budget?

That is what he is taking about.

——aspects of the work of the Department that are ongoing.

I want to come back to the central point. Some of the issues raised by Deputy Kenny can and should be answered in full. They will be answered in full but I am explaining the context in which all of this is happening. The real point to make is that every effort will be made to work with people providing disability services. How do we reduce non-frontline expenditure so we have sufficient funding for the frontline? We all know some element of support expenditure has to be provided, no more than one cannot have a consultant in a hospital providing proper services without secretarial support. We all understand it is not a black and white issue but it is an issue that needs to be addressed and will only be addressed if we re-organise how the services are provided.

When will the Taoiseach start?

That is what we intend to do; that is how we intend to work with the services. In the meantime, we have to try to address the difficulties that arise in the context of the budget. Against the background of last year's budget, an extra €20 million——

What have you been doing for the past ten years?

If the synergies are there why did the Government not use them?

——over the 2009 spend was provided for disability services. In total it is in the order of €1.6 billion. I recall when I announced in this House a five year programme for the development of disability services what the initial baseline figure was. That aside, it does not take away from the fact that issues arise today that we want to try to resolve but they can only be resolved if we approach it in the way I suggest.

When will the Taoiseach start?

To suggest it would be resolved otherwise, simply by providing for more expenditure regardless of the budget situation, is not being honest or straightforward with the people with whom we want to engage on this issue.

The best value is in the voluntary sector and the Taoiseach knows that.

What has the Government been doing for the past ten years?

The free travel budget.