Concern over rise in number of private residential centres for people living with intellectual disability

Social Democrats TD for Cork East Liam Quaide said that the increased privatisation evidenced in the figures 'will result in poor outcomes for our disabled citizens'. Picture: Chani Anderson

The number of for-profit residential centres for people living with an intellectual disability nearly doubled over the past four years, sparking concerns about the quality of care being received.

New figures from the HSE show that some 1,353 people with intellectual disabilities are currently being cared for in their residential placements by private, for-profit companies, representing more than 15% of the 8,834 such placements in total in Ireland. 

That compares with the 8% figure noted by the HSE as recently as 2021, indicating the reliance on the private sector to care for some of the most vulnerable people in society is growing.

The figures, released to Social Democrats TD for Cork East Liam Quaide, show that the HSE itself provides residential care for 1,074, or 12%, of the people in question, indicating that the private sector currently directly accounts for more of those placements than the official health service.

The remaining places, accounting for 6,384 people, are provided by Section 38 or Section 39 agencies — independent non-profits funded by the HSE.

Mr Quaide, a prominent advocate for those living with mental health illness or a disability, described the new figures as “concerning”.

He said that the increased privatisation evidenced in the figures “will result in poor outcomes for our disabled citizens, and represents a clear move away from a whole-person, client-centred approach to service provision".

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The for-profit care sector in Ireland has been embroiled in controversy before, most recently when dubious care practices were exposed following an RTÉ investigation at several nursing homes run by a private multinational in Laois and Dublin last summer.

A spokesperson for the HSE said that the demand for full-time residential placements within designated centres is “extremely high”.

“The HSE acknowledges that demographic challenges associated with the increase in the number of people living with a disability, the increase in age and life expectancy and the changing needs of people with a disability have all led to the need for increased residential facilities,” they said, adding that responsibility for the provision of suitable housing lies with the Department of Housing.

'Even more troubling'

Mr Quaide said however, that “what is not revealed” by the HSE in its responses to him “is even more troubling” than the verified figures released concerning for-profit care.

"The HSE is not providing a breakdown of wait times for residential placements,” he said.

“They are also declining to clarify the number of people with an intellectual disability living in facilities far from home, detached from their community and family, which is a clear breach of rights under the UN Convention on the Rights of People with Disabilities,” he added.

In his parliamentary query to the HSE, Mr Quaide had specifically asked for the number of adults with an intellectual disability seeking a residential placement nationally, with a further breakdown in terms of how long those people had been waiting.

The HSE noted that 1,389 people were awaiting such a placement as at the end of June 2025, up 79% from the 776 noted in 2019.

However, the service declined to detail waiting times, with an official stating that there “is no centrally maintained waiting list for residential services”.

“The local HSE... areas would be aware of the need and requirements in their respective areas and would work with the local service providers with a view to responding to the level of presenting needs within the resources available,” they said.