I have raised on a number of occasions in the House the value and importance of the hospice movement and the enormous public support it enjoys from many volunteers and the public generally who fund and contribute to hospices. In particular, I refer to Marymount in Cork, Blanchardstown, Raheny, Galway Hospice and the mid-west hospice in Milford, Co. Limerick. They are continually being disadvantaged by Government policy and left in unsustainable positions in terms of funding, recruitment and retention. The recent Workplace Relations Commission, WRC, agreement worsens their position and creates an unsustainable funding pathway for them to retain and recruit staff because essentially it breaks the historic link these hospices had with their HSE employees and confirms a two-tier workforce in perpetuity. The agreement covers only those who worked in the hospices at the time the FEMPI legislation was introduced. New people coming in are not covered. There is no retrospection.

The entire approach of Government for the past year and a half has been as mean-spirited as one can get towards these hospices. It is a slap in the face to the thousands of volunteers who support them and to the public who fundraise for them. It flies in the face of the national palliative care strategy, which the Government announced with fanfare last year. It is also contrary to the policies of Sláintecare, which recommends full integration of palliative care with acute hospital care within the health service. Hospices are an essential part of our health service; they are not an ancillary service. The Government's approach to pay policy has been to continue to treat them as an ancillary service. They provide community care, home care packages and vital interventions at critical parts of a person's journey with cancer or other serious illnesses. Their model is the one we should aspire to for other areas of care within our health services. They are enormously important in alleviating pressures on acute services.

I met with representatives of Marymount Hospice yesterday. It costs approximately €20 million to run it on current funding, some €3 million of which is raised by the citizens of Cork and the surrounding region. The same can be said of Milford, Galway, Blanchardstown and Raheny, yet they are treated in a discriminatory manner by the Government, which must stop. In Marymount's case, as the people to whom I spoke made clear, they had to fund the pay restoration under the national agreement, which cost €277,000 in 2017, €562,000 to date this year and is expected to cost €798,000 for the full year. They told me they cannot afford to deliver the current quantum of services. Decisions are under consideration and review about cuts to services. They had to cancel community visits to people and they are considering closing specialist palliative care beds in the hospice, which could happen as early as next January.

Is it not time to treat these hospices as essential parts of our health service, as other hospitals and health institutions are, and transition them to section 38 agencies in order that they can enjoy the same pay scales as everybody else within the HSE?

I acknowledge that the Deputy has raised the importance and value of our hospices and the hospice movement on many occasions. He often mentions Marymount, which he knows well, and St. Francis Hospice in Blanchardstown and Raheny, which I know well as a constituency Deputy. We have seen enormous improvements in recent years in end-of-life care and palliative care, ensuring more people die in a hospice or at home than in a hospital. This means that, in general, people who are in their final few days or weeks can pass away with dignity and comfort, managed in a pain-free environment, in a way that is much more difficult to do in a busy hospital. Those improvements will continue and new hospices are being provided in Wicklow and Castlebar, for example. There are also plans to develop palliative care in Drogheda and Waterford as well as the midlands, should we be able to come to an agreement among the different counties on an appropriate site.

As the Deputy mentioned, Sláíntecare proposes that palliative care become universal, but it does not specifically propose that it be taken into the public sector as a section 38 agency. Rather, it proposes that it be universal. When I asked the Sláintecare team what that means, it said that it should be provided in all parts of the country because it is not now, or at least not to the extent that it is in other parts. There has been much Government support for hospices in recent years, such as for St. Francis Hospice, to which the Deputy referred, where the land was provided by the Government through my predecessor, the late Deputy Brian Lenihan, while the equipment and staffing were provided by this Government when we came to office.

The agreement to which the Deputy refers was brokered at the WRC. It acknowledges there is a difference between section 39 and section 38 bodies, as he will understand. The difference is that section 39 bodies are typically charities, private institutions and, in some cases, companies. They are not part of the public service and they are not owned by the public. The land and the buildings are not owned by the public, and nor are the pension liabilities or the debts. If some bodies want to move their classification from section 39 to section 38, we can consider and talk about that, but there will also be consequences to that, namely, relating to ownership, legacy pension liabilities, legacy debts, control, membership of boards and so on. These matters would have to be resolved. If some section 39 bodies are willing to give up some or all of their independence and transfer their lands and ownerships in return for becoming part of the public service, that is the type of thing we could discuss. The board of each individual section 39 body, however, would have to decide for itself that it wants to go down that road and it would have to be negotiated.

Words come cheap from Government. During the budget talks, the Taoiseach set his face against any consideration of bringing those agencies under section 38. He said it was not even being considered. He can make all the announcements he likes, such as the palliative care strategy or Sláintecare, but they mean nothing in the real world. When one comes face to face with the financial controllers of these institutions, who are trying their best and have been moderate in their response, it is clear that the Taoiseach does not value them.

He says he does. I get no pleasure in saying this but he does not value them, because if he did, he would not treat them as he does. He mentioned Wicklow. That will come in under Our Lady's Hospice in Harold's Cross. That means that it will be fully HSE aligned. The remaining hospices I mentioned will be further discriminated against. There will be a HSE hospice network while those in Cork, Limerick, Galway, Blanchardstown will be continually disadvantaged by the Government. The WRC agreement is a cover operation. The unions look after their members, which is their job. The Government gets to frustrate the whole thing for a year and a half and the Taoiseach can stand here and say that the Government has an agreement. In reality, behind the scenes, this puts an unsustainable strain on the hospices I mentioned. It is time for the nice words to end. People are no longer interested in the announcements that generate photo opportunities or the nice words that placate them in their daily duties.

I call on the Taoiseach to respond. The Deputy has exceeded the time.

Marymount Hospice is losing staff because of this arrangement.

I call on the Taoiseach to respond.

It has lost 11. The managers are cancelling community visits as we speak. They have been restrained up to now but this is not sustainable. I do not want the Taoiseach to say we can talk about it.

I call on the Taoiseach to respond.

These hospices need to be sorted out. They are essential. I have been on about this for the past year but my comments have fallen on deaf ears from the Government.

I call the Taoiseach to respond, please. I must have some control on the House and I must also think of backbenchers. While the topic is important, I must implement the rules and regulations.

It is welcome that we have a WRC agreement on pay. Negotiations ran for many months and we should welcome that thanks to the commission's work, with the co-operation of the unions and the Government's work, that there is now an agreement that provides for pay restoration for staff in section 39 bodies.

I do not agree.

That should not be dismissed out of hand. It was welcome.

I am not interested in platitudes either. I do not have the figures before me but I will dig them out.

It is being done. Midford Hospice has gone from 70% to 64%. The Government has reduced its contribution.

The increase in budgets for section 39 organisations compared to the HSE organisations has been greater over the past three years. I will produce those figures.

No, the Government has reduced its contribution to their revenue.

The Taoiseach to speak without interruption.

The Deputy always interrupts when he hears the facts. I may be totally wrong, but I am not aware of any section 39 body that has asked to be taken over by the HSE and to be nationalised. If there are any that are willing to do that, we are willing to consider it.

We asked.

However, it must be done properly. We cannot have a repeat of what happened with the voluntary bodies. If they want to be taken over, the ownership and the assets must be handed over as well.