The Tánaiste will be aware that the OECD has completed a review of the second public service reform programme. There is a lot of good to be found in the review. It found that improved transparency and accountability has been delivered, in large part because of the legislation we enacted to regulate lobbyists, to open up freedom of information and to protect whistleblowers. It also confirmed that public servants are delivering additional services with fewer staff and at less cost, which we knew. However, as I said earlier in the debate on the summer economic statement, this proves that the so-called hidden fiscal space is a ball of smoke, but I want to leave that discussion to another time.

The chief negative finding of the OECD report was that outsourcing has not emerged as a systemically viable option for providing public services. This finding will be welcomed by many people who have question marks about the operation of outsourcing initiatives. It also has a much deeper implication, including an implication relating to the continuing delivery of public services via section 39 agencies. These 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. In case anyone has forgotten about them, the Tánaiste knows them.

The internal audit that was focused on today in the Irish Examiner makes for stark reading. This is an audit of the Catholic Institute for Deaf People. 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 to address the particular example highlighted in the Irish Examiner this morning? More significantly, will the Tánaiste outline the general Government view on the provision of services through section 38 and section 39 agencies?

Is it now appropriate to begin the task of bringing all public services directly under the ambit of the State so that State-funded services will be provided by the State with all the controls and accountability that would bring?

The Deputy raised a number of issues. He started by referring to public sector reform and the OECD report. That report noted that the Public Service Reform Plan 2014-2016 was very successful, by and large, in terms of completing the majority of the activities it set out. The report outlined key lessons and findings. On the subsequent points raised by the Deputy on sections 38 and 39 organisations, 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. We now have an organisation tasked with dealing with charities that do not have proper governance and are not abiding by the rules. The regulator has the ability to initiate and carry out inquiries and it has already done that. The charities sector is becoming increasingly aware of the challenges around governance and the need for proper financial reporting, auditing and so forth.

The Deputy referred to the mix between the public and private sectors in the health services. We have that mix at present. There is also the history of the religious being involved. The Minister for Health is bringing forward actions to begin to address this. He will analyse it and decide what is the way forward in terms of separation. 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. However, the Minister is determined to examine and address that and to assess what the pathway forward might be.

I thank the Tánaiste for indicating that there is a review of these matters. We must make 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. There is no uniform national baseline in terms of resources, staffing or quality of service. That is no longer valuable. Will the Government go further than simply examining the voluntary hospitals and examine all public service provision to assess whether we can have the objective of having the State, which funds all the services in any event, providing and being responsible for those services, as is the case in most progressive western European countries?

What the Deputy said has widespread implications for the role of the community and voluntary sector in providing services. That role has been very valuable and is hugely valued by our communities. We have some excellent services. The idea that every service would solely be in the charge of, and run by, the State would require a great deal of consideration and might not even be desirable. What we need are clear governance arrangements and clear partnership where there is that mix of the public and private sectors. To suggest moving to a model that is one dimensional would be very extreme. As I said, the Minister is examining that mix in the health service. However, it would have huge implications and huge budgetary implications, as the Deputy knows. The Deputy has raised a topic on which there will undoubtedly be more discussion, but I believe the mix we have in the country at present is valuable. A complete separation sounds like an extreme response to the situation we have been discussing in some of our services.