2026-02-19

104. Deputy Claire Kerrane asked the Minister for Children, Disability and Equality the number of special care beds that are open currently; and if she will make a statement on the matter. [13218/26]

I ask the Minister to provide details on the number of special care beds currently open. Across the three special care units there is capacity for 26 beds. I do not know if all 26 beds have ever been open but would like to know how many are open today.

I thank the Deputy for her question. While the operation of special care and the provision of special care beds is the statutory responsibility of Tusla, the Department is actively engaging with Tusla in relation to the challenges impacting special care. There are four young people currently subject to a special care order who are awaiting placement in a special care unit. I am advised by Tusla that as of 16 February 2026 there are 15 young people in special care, with additional staffing of 2:1 required for at least one young person due to complex presentation. This means an additional seven staff, or 14 in total, are required to meet the needs of that one child. This is the equivalent of an additional special care bed. Tusla has indicated that difficulties in the recruitment and retention of staff are the primary limiting factor in capacity in opening special care beds. Officials from the Department continue to work with Tusla to support it in addressing the staffing shortages in special care provision. A new grade and pay scale for special care was sanctioned in 2024 in an effort to increase staff numbers and has been advertised since January 2025. This new Tusla special care worker grade offers approximately 20% higher pay at the top of scale compared to the social care worker grade. The Department has also provided a substantial budget increase for Tusla in 2026, rising by 14% to €1.37 billion. This represents the fourth consecutive year in which Tusla’s budget has exceeded €1 billion. In addition, €26 million has been allocated for special care in budget 2026. This represents an increase of over €6 million on budget 2025. This investment will increase capacity and enhance provision, including funding for the new special care staff grade, staff well-being initiatives and additional therapeutic supports. Tusla has been allocated €188 million in capital funding for 2026 to 2030. Reflecting the priorities in the national development plan, €17 million is the indicative allocation for special care in Tusla’s capital plan for 2026 to 2030. This will support Tusla in upgrading, renovating or purchasing special care and step-down units. In this context, the expansion of dedicated step-down provision from special care is progressing.

It is really alarming to hear that four children in the State need a special care bed but there is not one there for them. I appreciate, understand and welcome the change to the payscale made in 2024 but we need to look at that again to see whether it is enough in the context of recruitment and retention of staff. I have raised with the Minister previously the report of the external review group on special care which raises the same issues around staffing and capacity. That report, published in April 2025, identified that since 2021 a total of 168 staff had been hired but 134 had left. There is capacity for 26 beds across the three special care units but I gather from what the Minister is saying that we only have staff for 15 of those 26 beds. We have four extremely vulnerable children who have no bed, so we need to look at the pay scale again. We need to look at that external report again and at the recommendations within it.

Deputy Daly has a related question.

My question similarly relates to vulnerable children. Following the Halpin report into CAMHS in north Kerry which showed deficiencies in care and a departure from standard operating practice, can the Minister confirm that the compensation scheme will be widened to include people who have had an apology already from the HSE and that the review will be widened to a much broader category of children who have been dealt with in the north Kerry area?

The Deputy attended the briefing with me provided by the Minister of State, Deputy Butler, on the north Kerry CAMHS report. He will appreciate that it is not in my remit; it is within the remit of Deputy Butler. It is my understanding that she will make further announcements as regards the extension of the look-back and issues around compensation. The Deputy will respect that it is appropriate that she as the line Minister of State does that. On the points raised by Deputy Kerrane, there are so many complexities in this instance. As I previously referenced with Deputy Ó Murchú, there is one instance where 14 staff are required for the care of one child. It is right that we provide those 14 staff but in normal instances that is two beds being required, such are the complexities. There have been significant improvements, such as the new pay grade with a 20% increase. It has yielded 27 additional people being recruited. Significant recruitment is taking place abroad in South Africa and the Philippines which is also garnering success. The work continues.

I would like to see a timeline for the implementation of each of the recommendations of the external review group. Fifteen special care beds are open but we should have 26. There are four extremely vulnerable children who have been advised, told and directed to special care but it is not available for them. The report is especially damning. It describes "severe challenges" and talks of a "crisis". The report makes it clear that it looks at "the immediate operational issues", or what needs to be dealt with immediately. It also goes on to discuss the children in dire need of intervention - our most vulnerable children - for whom there is no bed for special care. The recommendations of the review group need to be looked at. It is always important to say that this is not just a matter for Tusla. There are other agencies that need to get around the table on these issues. We need to look at what we can do in relation to special care because what is going on at the moment with beds not being open is just not acceptable.

I want to be clear, in terms of the financial resources being made available, that €26 million has been provided for special care, with an increase of €6 million specifically in terms of the provision of beds. The financial resources are in place for staffing. There is an absolute challenge in staffing which is not unique to us. It has already been referenced that it is in other disciplines as well. There are new programmes. I outlined to the previous Deputy the types of the increases in places, in-house training for staff so they can step up into special care roles, and recruitment from abroad. There is a whole suite of efforts being made. It is an absolute priority. There is an absolute commitment that all of those recommendations for any Department or agency will be addressed and implemented in full.