Revealed: HSE paid five private, for-profit firms over €300m for disability services in 2025

The figures show that the HSE spent 58% of its expenditure on commercial companies, or just 2% of the agencies in question. File picture

The HSE paid at least €306m to just five private, for-profit companies for the provision of disability services in 2025, the Irish Examiner can reveal.

That figure forms part of a wider €526m spent on roughly 220 companies providing such private care for people living with disabilities in the same year.

The new figures, released to Social Democrats TD for Cork East, Liam Quaide, show that the HSE spent 58% of its expenditure on commercial companies, or just 2% of the agencies in question.

While the disabilities budget has ballooned in recent years, jumping from €2.8bn to €3.8bn between 2024 and 2026, heightened spending on for-profit has led to criticism that it is unclear how much of that spend is being utilised to provide much-needed residential accommodation for highly-vulnerable users.

The HSE estimated its funding for disability residential services at €1.7bn in 2024. 

However, it has repeatedly stated that it is not possible to extract the level of spending on for-profits for residential services alone, given that those companies provide multiple other services within the disabilities sector, and which are all accounted for under the same governance system.

In 2024, the HSE spent €295m on the top five for-profits in the disabilities sector, with those five companies being Nua Healthcare Services, Talbot Group, Resilience Healthcare, GAIRO, and Orchard Community Care. With a spend of €128m, Nua Healthcare accounted for just under 45% of that spend alone.

By contrast, the spend on the same five companies in 2020 was just €129m, representing a hike in funding of 129% in just four years.

Mr Quaide said he had been seeking the spending on for-profits from the HSE for six months, and that it had taken “far too long to extract even this broad figure”.

He said: "Approximately €526m in 2025 to around 220 for-profit disability providers is a very significant sum.

“This still falls well short of transparency. It does not show how much relates specifically to residential services, how much relates to children as against adults, or what the exact expenditure was.

“Taken together with the growing role of for-profit operators in disability service provision, this trend points to a system that remains fragmented, reactive, crisis-driven, and a failure to forward plan in the most basic way for people with an intellectual disability and their families."

Of the figure of €526m, a HSE spokesperson said that the providers in question “deliver a range of disability services, including residential, day and respite services, as well as home support, personal assistant services, and therapeutic assessment and intervention”.

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Roughly 16% of residential services are now provided by for-profits, a figure which has doubled in just the past five years.

“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,” a spokesperson said.

They added that the health service is “working closely” with the Department of Children with a view to achieving “a more balanced response to the demand for residential placements”.

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