Dáil Éireann Debate, Tuesday - 23 June 2026
72. Deputy Liam Quaide asked the Minister for Children, Disability and Equality the steps being taken to address the growing reliance on private for-profit residential disability providers; the safeguards in place regarding cost, quality, distance from home and long-term planning; whether Government policy is to reduce reliance on for-profit provision; and if she will make a statement on the matter. [47546/26]
Amharc ar fhreagraI wish to thank the Deputy for raising matters relating to the provision of disability services.
This Government is committed to ensuring that residential services for people with disabilities provide a good quality service that is safe, effective, and provides a home from home environment for residents.
As of April 2026, the HSE, together with approximately 90 service providers are currently providing 9,031 residential places to people with disabilities.
Through a robust Governance Framework, the HSE works in partnership with organisations including Section 38, Section 39, Out of State and private organisations to ensure the best level of service possible is provided to people with a disability, and their families.
The majority of disability service provision in Ireland has historically and continues to be provided by voluntary agencies, which are funded under Section 38 and Section 39 of the Health Act 2004.
Demand for disability services, particularly residential services is very high due to a number of impacting factors including change in need and 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 advance of admission to any service, the Service Provider ensures it can meet the needs and requirements of the service user. Acceptance of referrals are contingent on the ability of the service to meet the client’s assessed need.
Following referral and assessment, available resources are allocated to clients on the basis of priority need and available resources. Placement decisions are made in close consultation with individuals and families, incorporating clinical advice, personal preferences, and service availability and resources and options available.
Funded placements undergo reviews focused on the individual’s satisfaction, wellbeing, continuity of supports, and engagement with personal planning processes, in accordance with the National Standards and Health Act regulations.
While every effort will be made by the referring agency to ensure the provision of residential services for the service user is close to family/natural supports and that will and preference is taken into account, there are various important caveats to be considered, not least, as outlined above, the availability of a suitable residential place that can meet the unique and assessed needs and requirements of each individual.
Each case is reviewed regularly where transition closer to home is the will and preference of the individual. HSE areas are endeavouring to move individuals back to the region through capacity building.
With additional funding secured in recent Budgets, new HSE housing coordinators and residential planning and review teams will be in place this year to coordinate and oversee the delivery of the new residential placements and plan for future placements.
The HSE continues to work alongside service providers to build the capacity of Section 38 and Section 39 organisations to deliver more residential services.
HSE disability programme leads are developing a national procurement framework for for-profit residential providers, with a focus on securing group-based placements.
Furthermore, the HSE is establishing Residential Placement Planning & Review Teams within each Regional Health Area, to ensure that individuals’ needs are appropriately assessed and reviewed on an ongoing basis while in a residential placement.
