The report that the HSE is to cut €80 million in direct State support from community and voluntary organisations is disturbing because it potentially impacts those who are most economically vulnerable and threatens employment in those entities threatened with cutbacks. The State spends a lot of money in the community and voluntary sector but how adequate is the value obtained for this money?
The HSE provided a total of €3.91 billion in revenue grants to approximately 630 community-based entities in 2009. These had a combination of very far-reaching objectives, some of which seem similar to each other. The sum provided in 2009 is €1 billion more than was provided in 2005 – a 33% increase during a period when the population of the country increased by 8%. The current health budget of the country accounts for a quarter of the national budget and almost half of all taxation so the argument to achieve greater economies and reassessed priorities is urgent, compelling and unavoidable.
Are the vulnerable or needy genuinely best served by all of the organisations that receive HSE grants? Does the proposal to cut back overall funding not present an important opportunity to begin to streamline the community and voluntary sector; to eliminate the provision of State funds where there is avoidable duplication of effort; to weed out support of organisations that are wasteful, ineffective, or who fail to account adequately for funds provided?
Should more resources not be provided to those entities that really make the greatest credible impact on alleviating distress throughout the country, if it can be clearly demonstrated that effective use could be made of incremental resources? If so, are they not the most deserving of State support and ought they not have an unchallenged priority above the half billion euro that is now spent annually, but funded by costly national debt, on development aid across the globe? That expenditure delivers no direct local benefit to Ireland. Charity begins at home and when the national income of the country starts to grow wider priorities can be considered. But in the meantime the funding of the economy is not sustainable on dollops of enormous national debt that will crucify future generations of modestly paid Irish taxpayers, if they are lucky enough to be in employment, or to operate a business or a farm that is not starved of bank credit.