HSE cannot provide figures on spend on for-profit accommodation for people with intellectual disabilities

Liam Quaide: 'At a time when €3.8bn has been allocated for disability services, it is indefensible that Government cannot clearly identify how much is being spent on for-profit residential provision.'

The HSE has said it cannot tell how much of its €2.2bn budget is spent on corporate for-profit accommodation for those living with intellectual disabilities, a sector which has nearly doubled in size in recent years.

The health service has previously acknowledged for-profit residences for those with intellectual disabilities climbed from just 8% of total placements in 2021 to 15% of the nearly-9,000 placements available in just four years. This has sparked fears about the quality of care being provided and the system by which those placements are allocated.

In last year’s budget, the HSE received a record €3.8bn in funding for the disabilities sector, €2.2bn of which was allocated to the provision of accommodation.

However, a spokesperson said it was not possible to tell how much of that money was being paid to corporate entities.

Funding for providing accommodation services itself doubled from €1.1bn in 2018 to the levels seen in late 2025, according to the HSE’s own figures, which were released to Social Democrats TD for Cork East Liam Quaide.

Asked why such an enormous budget could not be extrapolated to show how much of it was being spent on corporates, the HSE spokesperson said although for-profits provided a wide variety of services to the State, the nature of the HSE’s own service provider governance system meant it “is not possible to differentiate which of those private organisations provide disability residential services only”.

They said a governance framework for funded agencies “ensures appropriate governance arrangements underpin the release of funding” in order to “reflect the requirements for public accountability”.

Mr Quaide said the HSE’s response “raises serious concerns about how disability residential services are planned, funded and overseen”.

“At a time when €3.8bn has been allocated for disability services, it is indefensible that Government cannot clearly identify how much is being spent on for-profit residential provision, and that no figures are supplied for children’s residential services,” he said. 

The levels of for-profits operating in the Irish health market have caused concern in recent times, notably with regard to nursing home services, amid suggestions relying on large-scale organisations focused on profit-making and cost-cutting could lead to a substandard level of care.

Last summer, a number of dubious care practices were exposed at several nursing homes run by a private French multinational in Laois and Dublin.

The HSE said it understood “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” in the sector.

“Consequently, in many instances, HSE and voluntary organisations have not been able to access housing. The solution to the immediate need has been a reliance on private providers,” they added.

Last November, the minister with responsibility for the sector Norma Foley told the Oireachtas Disabilities Committee she was “not happy” with the fact a “reliance” had been allowed to develop “to meet emergency needs in particular”.