More than 80% of disabled children requiring residential care placed in for-profit facilities by HSE

The HSE has been unable to provide a reason for why child disability placements have increased so rapidly, bar noting that up to 60% of new cases are co-funded by Tusla, the child and family agency. File picture

The HSE has admitted that placing disabled children with private care providers “is not a strategy” after it emerged that more than 80% of such cases end up in for-profit residences.

The Irish Examiner has learned that of the 296 residential placements provided by the State for disabled children, 242 of them, or 82%, are provided by commercial operators.

The new figures were released to Cork East Social Democrats TD Liam Quaide via parliamentary question, with Mr Quaide describing the situation as “a reactive, ungovernable, crisis-driven market shaped by what commercial providers are willing to supply”.

For profit care is typically associated with problems in terms of staff retention and workforces that are paid less than their statutory equivalent.

As a result, staffing in such institutions tends to be more transient, presenting issues in terms of continuity of care for some of the most vulnerable children in society.

Asked what strategy underpins so many young people being placed with for-profits, a HSE spokesperson replied: “The current level of placements with for-profit providers is not a strategy.

“Rather, it reflects the need to respond to urgent and complex cases where children require residential placements, often at short notice, in order to support the individual and their families,” they said.

“In many cases, private providers have been able to respond more quickly to immediate needs.”

The number of children, as young as three years old, with disabilities living in State residences has exploded over the past two years, jumping from 155 at the end of 2023 to its current level of almost 300, an increase of close to 100%.

Advocates say the use of such accommodation should be a last resort, suggesting that many such placements could be avoided if earlier and more consistent treatment is given to allow the children to stay in their own homes.

Separately, the Irish Examiner has recently reported that at least 24% of children with disabilities in State-funded accommodation are living more than 50km from their home.

The ratio of children in for-profit accommodation is consistently a great deal higher than the number of adults in a similar situation, with just 17% of overall disability placements being delivered by private companies.

Call for change

A heightened dependence on for-profits for child disability care is not a recent phenomenon, though it has deepened over the past three years.

As at end 2023, some 111 of such placements were provided by commercial institutions.

The HSE has been unable to provide a reason for why child disability placements have increased so rapidly, bar noting that up to 60% of new cases are co-funded by Tusla, the child and family agency.

No age-related data is collated by the HSE with regards to child placements. making it impossible to know the life-stage the children in question are at , due to the “limited” practical reporting functionalities of the Excel-based file used to track placements.

“The Government has become dependent on commercial providers without the structures needed to plan where services are developed, enable children to remain close to their families and communities, protect them if a provider withdraws, or control costs to the State,” Mr Quaide said, while calling on the Government to “urgently develop a clear plan to phase out for-profit provision”.