Dáil Éireann Debate, Thursday - 19 February 2026
98. Deputy Liam Quaide asked the Minister for Children, Disability and Equality if she plans to phase out her Department's current and increasing reliance on private for-profit companies for the provision of disability services; if she will commit to multi-annual funding of State, not-for-profit providers; and if she will make a statement on the matter. [12931/26]
View answerI wish to thank the Deputy for raising matters relating to the provision of disability services.
This year, this Government has provided €3.8billion in funding to the HSE for the provision of Specialist Community-Based Disability Services, representing a 20% increase on last year.
Residential services make up the largest part of the Disability funding disbursed by the HSE, almost 60% of the total budget. Some 90 service providers provide residential services to 8,911 individuals throughout the country. Approximately 16% of these placements are provided by private-for-profit providers.
To meet the specific needs of each individual, the HSE works in partnership with both not-for profit and for-profit organisations to ensure the best level of service possible is provided to people with a disability and their families, within the available resources.
Demand for disability services, particularly residential services is very high due to a number of impacting factors including a change in need and the availability of appropriate housing. This has led to a situation where the HSE must respond to emerging urgent cases and in some circumstances, the most appropriate placement with immediate availability is with a private-for-profit provider.
The Department of Children, Disability and Equality is working closely with the HSE to achieve a more balanced response to the demand for residential placements and a move towards planned provision and away from unplanned responses where possible. This will include the development of housing to ensure all sectors will be able to respond to need including the HSE and Section 38 and 39 organisations.
In respect of private-for-profit providers, HSE Disability programme leads are developing a procurement framework for residential placements with for-profit agencies which will focus primarily on purchasing placements on a group basis. This is expected to improve the ability of the HSE to negotiate more cost-effective placements. The procurement framework is expected to be in place by Quarter two 2026.
It is important to note that all designated centres for people with a disability, including private for-profit services, are regulated by the Health Information and Quality Authority (HIQA).
This Government is committed to providing services which promote a good quality of life for all, and I must acknowledge the role of service providers, which comprises the HSE, Section 38, Section 39 along with private providers in delivering good quality, person-centred care in line with the UNCRPD, Government and HSE policies.
In respect of disability residential services, €65 million has been allocated in 2026 for new developments. €40 million of this funding will provide 199 new residential responses. This includes 152 new residential placements, comprising of 80 new placements to meet urgent need and the development of 72 new planned residential placements, as well as provision for the requirements for new residents entering into existing funded placements that have become vacant and in limited circumstances, placements in nursing homes.
The remaining €25m consists of:
• €6m to support approximately 40 residential packages for children in care with complex needs, in coordination with Túsla.
• €6m to enhance in the region of 38 existing residential placements for individuals whose support needs have increased
• €3m for decongregation, to support the transition of 58 people from congregated settings to more appropriate homes in the community.
• €10m for U65s in Nursing Homes, which includes €8m to support 45 transitions to more appropriate settings, and €2m to enhance quality of life for those remaining in nursing homes.
Additionally, within the funding allocated for 2026, the HSE has begun work to establish Residential Placement Planning & Review Teams in each Regional Health Area. The aim of these teams will be to improve forward planning of residential placements, and to ensure that individuals are appropriately assessed in relation to support needs prior to placement in residential services and reviewed in a timely manner for duration of the placement in respect of quality of care and support needs.
The HSE is working with the voluntary sector to build capacity to provide more residential services and a proportion of the planned places being provided this year are expected to be provided by not-for-profit organisations. HSE regions are working collaboratively with voluntary service providers in each Integrated Healthcare Area to identify individuals with urgent need to ensure plans are in place before a crisis arises.
Unlike the position for capital expenditure, where multi-annual commitments are made within the National Development Plan, the Estimates process for current expenditure allocates funding on an annual basis and no formal mechanism currently exists to provide funding on a multi-annual basis to providers.
Each year, the Department of Children, Disability and Equality works closely with the HSE to ascertain the requirements for funding for disability services to support current provision and expand services where required. Any new funding secured through the annual Estimates process is allocated to the health regions to provide services to those with the greatest need on a priority basis.
