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Proposed Transfer of Community Welfare Services

Submission to the Joint Oireachtas Committee on Social and Family Affairs on the proposed transfer of the community welfare services from the Department of Health to the Department of Social and Family Affairs - June 2006

Joint submission by SIPTU and IMPACT Trade Unions

Summary of main points
  • SIPTU and IMPACT represent community welfare officers (CWO) and superintendent community welfare officers.
  • IMPACT and SIPTU are opposed to the proposal to transfer the community welfare service from the Department of Health and Children to the Department of Social and Family Affairs, because it could undermine the quality and range of services that community welfare officers provide to some of the most vulnerable people in communities across Ireland.
  • The report of an Interdepartmental Review Group, Core Functions of the Health Service Report, was drawn up without any study of the work of CWOs and without consultation with those who manage, deliver and use the community welfare service.
  • SIPTU and IMPACT refute the report’s description of the CWO role as “more welfare supports than personal social services.”
  • As well as making welfare payments, CWOs provide a key information, advice, advocacy and referral links to statutory health and personal social services.
  • A transfer of the service to the Department of Social and Family Affairs would seriously undermine the range and quality of community welfare services because the Department would be unlikely to continue to devote resources to health functions for which it is not responsible.
  • The ability of CWOs to make discretionary payments is vital to the flexible and speedy reaction that characterises the service. Yet core functions of the Health Service Report makes clear the intention of restricting CWO’s discretion after a transfer. Furthermore, the discretionary element of payments would not survive within the Department of Social and Family Affairs’ culture and structure over time.
  • The proposals to transfer the service to the Department of Social and Family Affairs is based on a fundamentally flawed understanding of the requirements, purpose and functions of the service and would inevitably result in a separation of health and personal social services over time, which would damage clients and contradict the first recommendation of the interdepartmental group’s report.
  • A transfer would inevitably make services more remote from the communities in which CWOs operate and would, over time, adversely affect vulnerable clients by substantially lengthening response times.
  • IMPACT and SIPTU, and the front-line professional we represent, are therefore deeply opposed to the proposed transfer of community welfare services and seek the support of Committee members in preventing such a move.

Introduction

SIPTU and IMPACT together represent over 575 community welfare officers and 50 superintendent welfare officers. The two unions welcome the opportunity to make this submission to the Oireachtas Joint Committee on Social and Family Affairs on the Minister for Health and Children’s proposals to transfer the community welfare service from the Department of Health and Children to the Department of Social and Family Affairs. The two unions are also grateful for the opportunity to present oral evidence to the Committee on June 27, 2006, and are available to provide further information and views to the Committee on request.

This is the first time that IMPACT and SIPTU, and the front-line staff we represent, have officially been invited to express views on the proposed transfer. The two unions and their members are strongly opposed to the proposal, which we believe could seriously undermine the quality and range of services that community welfare officers provide to some of the most vulnerable people in communities across Ireland.

Background to the decision

On February 23, 2006 the Minister for Health and Children sought Government approval to transfer “income support and maintenance schemes, together with associated resources” from the Department of Health and Children to the Department of Social and Family Affairs. This proposal refers to services provided by community welfare officers and superintendent welfare officers, which have been situated in the Department of Health and Children since 1977.

The Minister’s proposal was based on the report of an Interdepartmental Review Group, called Core Functions of the Health Service Report. The review group was established in September 2003 and its undated report became public around the time that the Minister sought approval for the transfer.

The report made a number of recommendations. But, for the purposes of this submission, the key proposals were:

  • "1: Health and Personal Social Services should not be separated.
  • 2: Income Support and Maintenance schemes, together with associated resources should be transferred to the Department of Social and Family Affairs.”

IMPACT and SIPTU believe that these recommendations are incompatible as it is inevitable that, over time, health and personal social services provided by the community welfare service will be separated if the proposed transfer takes place. Furthermore, our two unions believe that the proposal was made without a proper study or understanding of the role and work of community welfare officers (CWO), which could be fatally undermined by a transfer to the Department of Social and family Affairs.

SIPTU and IMPACT believe that the poor understanding of the CWO role evident in Core Functions of the Health Service Report stems from the absence of consultation with frontline staff and managers of the service as the report was drawn up. The Interdepartmental Review Group that produced the report consisted of representatives of the Departments of Finance, Health and Children and Social and Family Affairs, but not of the Health Service Executive (HSE), which has responsibility for providing the service. Our understanding is that the review group did not consult the HSE. The review group consulted neither IMPACT nor SIPTU and, although its report claims “the group met informally with practitioners and senior officials” we have been unable to identify any CWO or superintendent CWO who met the group.

By its own admission, the research commissioned by the Interdepartmental Review Group, and on which it bases its recommendations, was “time limited” and “only able to draw general conclusions.” Our understanding is that the researcher was simply asked to make a short comparative international study. It was not a study of the existing service provided by CWOs and no one involved in managing, delivering or using the service was interviewed by the researcher.

In short, the research commissioned by the Interdepartmental Review Group did not study the service or the likely impact of the proposed transfer on service users and the Review Group did not consult the staff who provide the service or the unions that represent them. Neither did they properly consult the HSE, which manages the service.

This lack of consultation with anyone who manages, delivers, or uses the service is a major flaw in the report as we do not believe it is possible to make an informed decision on this important service without consulting those charged with the delivery of the service. As a result, SIPTU and IMPACT believe that Core Functions of the Health Service Report displays a fundamental lack of understanding of the service and the rationale for its home in the Department of Health and Children, fails to make a solid case for the proposed transfer, and represents an unsafe foundation for this important policy proposal.

In particular, and as we will demonstrate later, the report fails to understand the crucial link between CWOs and wider health and personal social services. It wrongly dismisses the CWO role as “more welfare supports than personal social services.” And it fails to address real fears that the proposal is an inevitable first step towards the abolition of discretionary payments to those in immediate, exceptional and dire need.

Links between Social Welfare Allowance and health and personal social services

Since its creation, the community welfare service has been firmly rooted in the traditions of a personal social service and it is no accident that the administration of Supplementary Welfare Allowance (SWA) was placed in the Department of Health and Children. The SWA scheme was placed within the community care structure with the intention of delivering a local response to individual need and providing access a range of health and personal social services.

When Frank Cluskey TD introduced the SWA scheme in 1977 he said it was intended to be more than a “mere cash response.” The scheme was seen to have a wider social objective of positive intervention, with a comprehensive range of non-monetary social work services, to help break the cycle of poverty in which some families and individuals found themselves. SWA was seen as an integral part of the overall social welfare income maintenance structure, but also as a scheme that would retain and develop its community-based element, often referred to as the “welfare role”.

The following extract from the Dáil debates clearly shows the two different roles envisaged when the scheme was being introduced (Dáil debates, June 24 1975, cols 1330-1331). It identifies the flexible, speedy income support role of the SWA scheme as well as the wider welfare role of the community welfare officer and the importance of a relationship between income maintenance and effective personal services.

“It is essential within any national system of social welfare to have a support service of last resort, which can enable immediate and relatively flexible assistance to be provided for those in need, who do not qualify for payment under other state schemes. Such a service should also help those whose needs are not adequately met under major schemes and those confronted with emergency situations. The problems of those who will need to avail of these allowances will in most cases be of a nature calling for more than a mere cash response. Social services, social work support and genuine community care are also needed. The reforms envisaged by this bill are designed to meet pressing need in a flexible and speedy manner. The diversity of recipients and the variety of circumstances which cause them to seek assistance require that there must be a considerable element of flexibility in the service to meet particular needs”.

The objectives of the Supplementary Welfare Allowance Scheme are to provide a standard minimum income in an immediate and flexible manner, to provide income support to those with additional specific needs, and to grant single payments to individuals with once-off exceptional and urgent needs that cannot be met from their standard minimum income. As we argue later in this submission, this function would be undermined if the service were transferred.

As well as making welfare payments, CWOs provide a key information, advice, advocacy and referral link between individuals and statutory and community services. The fact that CWOs operate in the community and with a significant degree of discretion allows them to make needs assessments and open access to a far broader range of health and personal social services, which clients would not otherwise be able or inclined to access. They include services to address issues like long-term unemployment, lone parenting, drug and alcohol use, asylum seekers, housing and accommodation provision, homelessness, social exclusion, and health problems.

Case studies A and B, which are set out in appendix one of this submission, are examples of cases that demonstrate in a concrete way how the CWOs' response to individual and family need involve far more than simply issuing payments. They are typical of the cases handled by every CWO and demonstrate how the description of the service as “more welfare supports than personal social services” is a profound misunderstanding.

Locating this provision within the health service is vital because poverty and ill health are inextricably linked. This link has recently been confirmed by all-Ireland research. Its location in health has allowed CWOs to provide financial assistance to the poorest and most marginalised in our society in a speedy and targeted way, working closely with local health service professionals including GPs, public health nurses, social workers, home helps and others. The location of the community welfare service in the community is also a strength. Working from a local base, the CWO presents the human face of bureaucracy, linking individuals, families, the community and various service providers.

The fact that the service is available in the community and with a significant degree of discretion also allows CWOs to respond quickly to newly emerging needs in ways that a large entitlement-based welfare department cannot. For example, the community welfare service responded immediately to meet the income and accommodation needs of the very large influx of asylum seekers in the 1990’s, allowing the State the breathing space to consider and amend immigration policy in light of this new reality. No other existing service was capable of doing this.

The first recommendation of the Core Functions of the Health Service Report is that health and personal social services should not be separated. But, in concluding that personal social services belong with the HSE, while community welfare services belong in the Department of Social and Family affairs, it ignores the crucial role of CWOs and SWA in delivering and opening access to health and personal social services.

Its recommendation to transfer the community welfare service rests on superficial distinctions between social care supports and income maintenance supports. People who have long term social and health problems do not easily categorise issues in such a way and policy based on such a division would lead to poorly co-ordinated services.

The Department of Social and Family Affairs’ approach to the CWO service has always been to distinguish between the costs of delivering the various SWA payment components (like basic payments, supplements, exceptional needs payments and the back to school scheme) and the cost of the other health and welfare functions. This is an understandable approach from an accounting perspective as it seeks to attribute costs accurately and identify the agencies to which these costs should be allocated. But the problem with this approach is that the other agencies have no particular incentive to countenance or identify any welfare or health functions relating to a payment function, for the obvious reasons that they do not wish to be pressurised into bearing the burden of these costs. SIPTU and IMPACT are, therefore, concerned that the poor understanding of the totality of the CWO function will inevitably diminish it over time following the proposed move to the essence of our service may be lost in this proposed move to Department of Social and Family Affairs. The unique culture of the community welfare service would be subsumed by the department of Social and family Affairs.

In practice, the Department of Social and Family Affairs cannot realistically be expected to develop an interest in identifying or meeting health or personal social service needs in the way that CWOs now do. These are not the Department’s responsibility and it would be highly unlikely to continue to devote resources to functions for which it is not responsible. This means the proposed transfer will, inevitably and seriously undermine the quality and range of services the community welfare officers provide to some of the most vulnerable people in communities across Ireland. The recent, and rescinded, decision to withdraw crèche payments, on the grounds that they were not a legitimate function of the Department, is a stark example of the potential fall out of transferring the CWO functions out of health.

Primary care strategy

The community welfare service is a key component of the Government’s primary care strategy, which proposes an integrated team-based approach involving inter-disciplinary teams of health professionals in treatment and preventative care.

Other health professionals within the primary health care teams have acknowledged the need to involve CWOs and have expressed concerns about the proposal to transfer the community welfare service. There are fears that the local responsiveness of the service and the ‘safety net’ of SWA may be lost, and that vulnerable groups including addicts, people with mental health issues, people with disabilities, single parents, victims of abuse, the elderly and those with chronic social, behavioural and psychological issues will find it harder to access health services. Health professionals recognise that, as members of primary, community and continuing care (PCCC) teams, CWOs bridge the gap between health and income maintenance and are an essential link in joined up person-centred service delivery. The links between CWOs and the voluntary sector are also essential to effective service delivery of both health and income maintenance.

Some of the practical ways in which the community welfare service contributes to the objectives of primary care include identifying those in need of primary care services, including the most vulnerable, and linking them to appropriate services and the provision of financial supports that can determine the success or failure of health interventions, including travel supplements to attend treatment programmes or to visit family in hospital, diet supplements and exceptional needs payments.

The need to maintain discretion in making payments

 The objectives of the Supplementary Welfare Allowance Scheme are as follows:

  • To provide a standard minimum income, in an immediate and flexible manner, to those whose means are insufficient to meet their basic needs (sections 189 and 196 of the Social Welfare Consolidation Act, 2005, as amended).
  • To provide income support in the form of a weekly/monthly supplement to those with additional specific needs, identified either in association with other personal and social services or on an individual basis that cannot be met from their standard minimum income (section 198 of the Social Welfare Consolidation Act, 2005, as amended, and SI No.382 of 1995, as amended).
  • To financially support, by way of a single payment, any individuals who have once-off exceptional/urgent needs, identified either in association with other personal and social services or on an individual basis, that cannot be met from their standard minimum income (sections 200, 201, 202, and 205 of the Social Welfare Consolidation Act, 2005, as amended, and SI No.382 of 1995, as amended).
  • Core Functions of the Health Service Report explicitly identifies “a more uniform approach to benefits” and “combining payments and supplements” as objectives behind the recommendation to move the community welfare service. This justifies the fear that, if implemented, the decision would fatally undermine CWOs discretion to respond to individual needs to relieve extreme hardship in extraordinary situations. The unspoken agenda is to limit or abolish discretionary payments, which make up a tiny part of the overall social welfare budget.

 

By their nature, existing statutory schemes do not, and cannot, be expected to provide the discretionary supports that CWOs can. There is a fundamental difference in approach between the SWA and Department of Social and Family Affairs. Within the SWA scheme, CWOs can make an immediate payments to meet identified needs using discretion where required. The CWO will generally conduct the appropriate means test, visit the client in their home, and assess entitlement within a matter of days and, in urgent cases, make an immediate payment. There is no separation of function in that the CWO conducts the interview, investigates the case, applies the means test, decides in consultation with the Superintendent CWO on eligibility, and subsequently sanctions and issues the payment. The ability to deal with the case in this manner is a major strength of the SWA scheme.

The Department of Social and Family Affairs, on the other hand, administers entitlement-based payments. Applications are processed by a number of different grades including clerical officers, investigating officers and deciding officers. The separation of the application into its component parts makes it extremely hard to prioritise and respond quickly to urgent need as claims are generally batch processed.

Contingency based schemes and the underlying legislative and regulatory framework continually give rise to unforeseen outcomes and administrative difficulties. The habitual residency condition (HRC) is an example of how a new piece of legislation can give rise to increased delays in processing claims within the Department of Social and Family Affairs. HRC applications are currently decided in a central unit within the department and local investigations do not commence until the decision on HRC is reached. The outcome has been an increased delay in the clients receiving their primary entitlement. The community welfare service has dealt with the consequences of this as the CWO makes the decision on HRC and assesses the client’s entitlement with no significant delays in meeting the client’s need. Other examples of unexpected difficulties are outlined in the case studies in appendix two of this submission. 

Conclusion

We have argued convincingly and on the basis of sound evidence for the retention of the community welfare service within the HSE and its primary care system, and against the proposed move to the Department of Social and Family Affairs.

IMPACT and SIPTU believe the proposal to be based on a fundamentally flawed understanding of the requirements, purpose and functions of the service, which may well result from the failure of the Interdepartmental review Group to study the existing CWO service or seek the views of those who manage, deliver and use the service.

SIPTU and IMPACT believe that the proposed transfer would inevitably result in a separation of health and personal social services over time, which would damage clients and contradict the first recommendation of the interdepartmental group’s report. We further believe that a transfer would inevitably lead to substantial reductions in the scope and quality of health and personal social services currently delivered by CWOs in conjunction with a wide range of other health professionals. The two unions also believe a transfer would inevitably make services more remote from the communities in which CWOs operate and would, over time, adversely affect vulnerable clients by substantially lengthening response times and reducing the discretion available to CWOs in making payments.

Our two unions, and the front-line professional we represent, are therefore deeply opposed to the proposed transfer of community welfare services and seek the support of Committee members in preventing such a move.

Appendix One – Case Studies

 

Case study A

Client A visited the welfare officer as she had signed for Unemployment Benefit/Assistance after losing her job in a local supermarket 2 weeks previously. She was therefore without a Basic income. On contacting the DSCFA they explained that the client had failed to supply the appropriate documentation, i.e. Birth Certificate, P45, Rent assessment forms, a written explanation regarding her reasons for leaving employment and evidence (including evidence in writing) regarding her efforts to find employment. In addition the client was provided with names of employers currently recruiting and asked to apply for these positions.

On the presented facts the case appears to be reasonably straightforward. The client should supply the required information and the DSCFA Local Office should make a decision on her claim. The key question in this and other similar cases centres on the client’s reasons for not supplying the required information. In this particular case it emerged that the client suffered from bouts of depression and that this was why she had left the job. One of the symptoms of depressive illness is an inability to concentrate. This had led to the client making errors in giving out change and consequently there were difficulties with her employer. The client felt that she was under a cloud of suspicion regarding her errors and that she had no option but to leave her job. Individuals suffering from depression tend to overestimate negative elements in a situation and underestimate the positive elements; this is a form of cognitive distortion. In addition those suffering from depression may be apathetic and listless and often feel physically unable to perform even simple tasks. They may be unable to concentrate to the extent that they are unable to assimilate information easily and may appear forgetful. This may easily be misinterpreted as being deliberately evasive.

In this case the client was reluctant to explain her situation to the DSCFA at a public hatch and was finding it difficult to get out of bed in the morning. The thought of contacting her employer for a P45 was also causing her considerable anxiety. She had visited the CWO because her sister had threatened to “put her out on the street” if she did not hand up money for her keep. The client was also reluctant to apply for DB or DA as she was opposed to labelling herself as being “mentally ill, like my mother.” The client’s mother had a history of severe depression and frequent hospital admissions for ECT. The client was terrified that in seeking medical help for her condition her treatment would follow the same pattern.

The CWO’s role in the above case involved much more than just an income maintenance function. Ensuring that the client has a basic income will obviously solve her immediate financial difficulty; this was also the beginning of a continuing process/dialogue with the CWO involving listening, assistance with her UA/UB claim, advocacy involving DSCFA, the former employer, and her sister, giving advice and information regarding depression involving medical and non-medical options.

Case study B

Client B called to the welfare officer to apply for SWA while her U/A claim was being transferred. She had been working but due to being beaten by her brother at home, had to leave home and at the same time had left her job. She was pregnant and the baby was due in a few weeks time. She had come into the area to live in her boyfriend’s sister’s flat to help with her three children. Her boyfriend’s sister is a drug addict who has made two suicide attempts. Client B was in a vulnerable position – not sure of what to do to get accommodation. She was in need of advice and support about this and the impending birth of her baby.

Through talking with her it was clear that she could not return home for the birth of her baby. She was informed about other options available, such as B&B or hostel accommodation, but she decided to stay in her boyfriend’s sister’s flat until after the birth. She was made aware of pre-natal classes available to help her prepare for the birth, about which she was quite anxious. After the baby’s birth, she and her boyfriend decided to leave the sister’s flat and move into her mother’s house, due to the chaotic situation in the flat. After further discussion she was advised to contact the local City Council office, to put her name on the housing list and to contact the housing welfare officer.

The move to her boyfriend’s mother’s house was not ideal as his mother was seriously ill and was due to undergo surgery within the next couple of weeks. The house is severely overcrowded – her boyfriend’s mother has three teenage children and in addition to client B, her boyfriend and their baby, another daughter, who was severely attacked and subsequently hospitalised, had recently moved into the mother’s house with her child. The pressures on everyone are considerable and despite client B having had a good relationship with her boyfriend’s mother, and having accompanied her on hospital visits, their relationship became strained.

To support Client B’s application for housing the CWO wrote to the Chief Welfare Officer and the city council’s Chief Medical Officer outlining the situation in the house. The mother was been advised to get a letter from her doctor confirming her medical condition to the City Council.

It is obvious from this case that simply making a payment would not have been a sufficient response to the situation. Listening and talking to the client, giving information regarding accommodation options and antenatal classes, advice and referral to the city council and advocacy involving the City Council have all formed part of attempting to respond fully to the needs of this particular need.

Appendix Two – Case Studies

Case study 1

Ms S applied for OPFP and SWA pending a decision on her claim. Ms S was found to be habitually resident and as she met all the required criteria for SWA was granted a basic weekly payment. A decision on her primary DSFA claim was reached after three months. Ms S was refused OPFP as she was “only separated by geography” from her spouse. There was no evidence that Ms S was in receipt of any financial support from her spouse. Ms S was advised to appeal the decision to the chief appeals officer. However she failed to do so within the prescribed 21 days and her appeal was not heard. Ms S subsequently submitted her case for consideration to the Office of the Ombudsman and made a re-application for OPFP. The client’s income needs continue to be met through SWA.

Case study 2

Ms M moved address and was required to inform the DSFA regarding her new address. This involved transferring her claim from one local DSFA office to another. Her claim was suspended pending investigation of her changed circumstances. In the course of the investigation she was advised that her Department of Justice card had date expired and that she should call the DOJ to arrange for a new card. Ms M subsequently called to the DOJ offices and they took her expired card and informed her that she would have to pay €100 for a replacement. Ms M was unable to afford the required €100. Ms M returned to the local DSFA office and explained the situation and was informed that they could not progress her claim until she presented with a valid DOJ card. She was advised to contact the CWO for assistance. Ms M’s case was assessed by the CWO and SWA awarded pending the resolution of her difficulties.




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