In July 2021, the Government published the Disability Capacity Review – A Review of Social Care Requirements and Capacity Demand to 2032. This review set out the extra capacity requirements for community disability services up to 2032, based on an analysis of demographic trends and unmet need. The Review estimated that between €550m and €1000m would be needed to bring service levels to the required capacity.
In order to implement the recommendations of the Capacity Review, a detailed Action Plan was developed. The Action Plan for Disability Services 2024-2026, published in December 2023 represents a national strategy for capacity increases and service and policy reform in disability services. It was informed by findings from the Disability Capacity Review, cross-governmental input, and an extensive public consultation.
It should be noted that the cost estimates in the Disability Capacity Review were based on unit cost and demand levels at the time at which the Review was written. However, the cost of delivering services has risen since 2018 due a variety of reasons. Therefore, a significant increase in current and capital expenditure, in excess of the estimates set out in the Capacity Review, will be required in order to address the scale of the challenge to manage an increased cost base and legacy deficits, as well as an increased demand for services.
It should be further noted that the Capacity Review noted significant data gaps in its analysis, meaning the true level of unmet could be higher than its calculations allow.
The planned improvements set out in the Action Plan will require additional investment, which would see current expenditures grow by 25% over 2023 funding levels over the three years of the plan. The planned expansion of residential services will require significant capital investment to provide the necessary housing.
The service areas for investment for 2024 under the Action Plan have already been agreed through the budgetary process. Specifically, €74m has been allocated for new development measures which will provide greater investment across a range of disability services and contribute to the progressive realisation of the Action Plan. The measures are:
• €20.5m for circa 100 Residential placements for children and adults
• €15m for provision of further Respite services
• €18.2m for new Day Services places for around 1,250 new users
• €8.5m for developments in Children's Services,including new circa 125 new therapy assistant positions
• €11.9m for other developments, including increased PA hours (80,000 new hours) and Community Neurological support.
The precise level of service delivery for people with disabilities, based on the funding provided in the Budget, will be set out in the HSE's National Service Plan for 2024.
To enable strategic planning of new current spending and achieve value for money over the full three years of the plan, it will be essential to have an indicative funding envelope, though year to year funding will fall to be decided through the Estimates process. It is intended to address the capacity deficits identified in the Capacity Review in a phased approach, meaning this Action Plan represents an implementation plan for the first phase and will be followed by a successor plan in 2027. The Action Plan is a living document and will be reviewed and updated in the light of priorities, policy considerations and the funding available under this and subsequent Budgets.
