I want to raise the issue of how we can ensure the continuation of vital community services across all our communities and pay and conditions for those workers who have been outsourced from the State and who provide vital care services through section 39 organisations or section 56 organisations. We all know how many community-based services in all our constituencies are utterly reliant on workers who are paid in this way - not directly by the State but indirectly by the State to provide vital public services. Labour will bring forward a motion in the House next week seeking to ensure better pay and conditions and, crucially, a framework for the sustainable delivery of public services across our communities through adequate resourcing and adequate recognition of a need for better pay and conditions for such workers.

We are conscious that until 2008, those employed in the community, voluntary and care sectors, such as section 39 workers, received pay increases under national wage agreements but they have not received pay increases since and they have no formal mechanism for collective pay bargaining. While public sector workers received a very welcome pay rise under Building Momentum, no pay rise or improvement in conditions was provided to the community and voluntary sector. We all know in our constituencies the vital public services provided by workers through these organisations, which include HSE-funded section 39 organisations, Tusla-funded section 56 organisations,section 10 homeless services funded indirectly through the Department of Housing, Local Government and Heritage and a broad range of community services such as those managed by community employment supervisors, whose salaries are indirectly funded by the State.

This was raised yesterday on RTÉ Radio by Noeline Blackwell of the Dublin Rape Crisis Centre, who spoke about the difficulty affecting services such as hers, which provide vital public services to support victims and survivors of rape and other sexual offences and sexual abuse but are doing so without adequate sustainable funding frameworks and assurances as to adequacy of pay and pay increases for staff employed through the mechanisms I have described - Tusla-funded section 56 organisations in that case. I was in Cork on Monday and heard from parents of children with autism and other disabilities about the difficulty accessing services through organisations that are finding it difficult to retain and recruit qualified staff. Children with disabilities and their parents are losing out as a result. Indeed, the Harvey report on the delivery of health services by section 39 organisations funded by the HSE found high annual staff exit rates of up to one third annually with further reports since then of workers leaving to take up direct employment in the public service, such as directly through the HSE, due to the pay gap and the gulf in terms and conditions. I heard in Cork about how the NHS is coming over to recruit directly from section 39 and section 56 organisations. Clearly, the pay and conditions the NHS can offer as a direct public service are far better.

We call on the Government to establish a renewed relationship between not-for-profit organisations and the State based on a shared long-term vision and plan and to ensure a multi-annual funding framework to provide certainty for providers, their staff and, crucially, for people like the parents I met in Cork with FUSS Ireland who are dependent on the vital services being provided to their children by workers who are simply not getting adequate pay and conditions compared with workers employed directly through the HSE. Will the Tánaiste undertake to look favourably on the terms of our motion and engage directly with the not-for-profit sector?

I thank the Deputy for raising the issue and I will certainly take a look at the motion and respond to it. It is not entirely accurate to describe people as having been outsourced. That does a disservice to them and even the bodies for which they work. It has always been the case in this State and almost every other democratic state that some services are provided directly by the State and others by voluntary bodies, charities and not-for-profit bodies, many of which predate the existence of the State, and private companies under contract. To try to do everything through the State sector would not work and to try to do everything through the private sector would not work. Excluding voluntary bodies or charities or trying to nationalise them would not work either. It makes sense to provide services in different ways using the public, private and not-for-profit sectors. That is how you get the most capacity and how you get the most done.

As the Deputy will be aware, section 39 organisations often provide a lot of services on behalf of the State. They range from very small organisations to some very big hospitals and disability service providers. They are usually funded through a service level agreement between the Government and the bodies, essentially through a block grant in return for particular services. The employees are not Government employees and we cannot determine exactly how the block grant is allocated by those providers. However, there will be significant increases in the block grants paid to section 39 organisations next year as a result of the budget. Indeed, there is €100 million in the budget in additional funding this year alone. We anticipate that the increase in the grant provided to those providers should be adequate to cover the cost of the public service pay agreement. This is only fair because it is not just the NHS or other foreign services that are trying to recruit staff from these bodies. The HSE is trying to do it as well and the HSE taking staff from voluntary bodies in that way is not fair. It is important that the block grant increase is adequate to cover the public sector pay increases so they can be applied to the staff in those bodies but we cannot determine that this is done because these are independent entities that control their own affairs and budgets.

One area where we are working very hard and to which the Taoiseach and I are very committed is moving the section 39 hospices into the section 38 category. This could be a precedent for others to follow. It does not always make sense but sometimes it does. These hospices that are voluntary bodies would prefer to be in the section 38 category and I strongly support that because there has been an unfairness and disparity in the way they are funded and the way the staff are treated because of that. We have been working on that and are keen to get it done soon.

I thank the Tánaiste for his constructive words. I do think it is fair to describe services as having been outsourced. Indeed, as the Tánaiste acknowledged, the State has a long history of outsourcing vital public services such as health and education to voluntary bodies, notably the Catholic Church and religious orders resulting in a shadow welfare state. Now in 2022, we need to ensure that we move to a different mode of delivery of services and that the State is stepping in to ensure those who are providing the same services as HSE staff but are doing so through being employed by voluntary bodies get the same pay and conditions, otherwise it is inevitable that the HSE, the NHS and others will seek to recruit them. The Tánaiste will be aware that pay claims have been submitted as part of the ICTU-led Valuing Care, Valuing Community campaign supported by SIPTU, Fórsa and the INMO in particular to ensure that staff working through these voluntary bodies, including section 39 and section 56 organisations, will have equivalent pay and conditions to their counterparts employed directly through the HSE and Tusla. Otherwise we will simply see a real diminution of services throughout the country.

This is not just done in Ireland. The NHS provides services through hospitals with royal charters and has done so since its establishment. In France and Germany, nearly one third of public health services are provided through voluntary bodies that have an agreement with the state payer. It is similar in Australia. One would have go to eastern Europe 30 years ago to find a set of public services that were only run by the state and excluded the private sector, voluntary bodies, charities and NGOs, and that is not something we want to do. We acknowledge the issue raised by the Deputy, namely, that there are staff working in section 39 bodies who are at a disadvantage compared with people doing the same work in an HSE-provided body. That is unfair and is something we want to rectify, first, by making sure the block grants of those bodies are adequate to cover the pay increases that will be paid in the public sector, which is only fair and, second, we will at least make an effort with the hospices to move them from section 39 to section 38, which is quite a complicated process when pension arrangements and so on are taken into account but is something we have committed to do.