2025-12-18

4. Deputy Liam Quaide asked the Minister for Children, Disability and Equality if she has completed an equality and human rights impact assessment of her Department's practice of locating people with intellectual and other disabilities in excess of 100 km from home in residential services for prolonged periods of time, and of her Department's failure to maintain statistics on these distances given their clear breach of the UN Convention on the Rights of People with Disabilities; and if she will make a statement on the matter. [72512/25]

Has the Minister undertaken an equality and human rights impact assessment of the Department's practice of locating people with intellectual and similar disabilities in excess of 100 km from their home in residential services for prolonged periods of time? Will she comment on her Department's failure to maintain even broad-brush statistics on these distances given their clear breach of the UN Convention on the Rights of Persons with Disabilities, UNCRPD, which enshrines the right of community living for people with a disability?

I thank the Deputy for raising this question and providing me with an opportunity to speak on this matter. The Government is committed to supporting people with disabilities through the implementation of the UNCRPD. To further the work in this area the Department of Children, Disability and Equality has recently published the National Human Rights Strategy for Disabled People 2025-2030. This includes commitments to promote independent living and active participation and supports our obligations under Article 19 of the UNCRPD. Demand for residential placements is very high for a number of reasons, including demographic challenges associated with the increase in the number of people living with a disability, changing needs and the increase in age profile of those in existing placements. The HSE advises that while every effort is made by the referring agency to ensure the provision of residential services is close to family and natural supports, taking will and preference into account, there are multiple important factors to be considered simultaneously in order to achieve a residential placement that will best meet the unique and assessed needs and requirements of each individual. Prior to placement, consultation with the individual and their family is undertaken and consent is documented as part of the decision-making process. A comprehensive needs assessment is undertaken by the multidisciplinary team to determine suitability and impact on the individual and their family. Funded placement reviews focus on areas such as the individual’s well-being and continuity of supports, in accordance with the national standards and Health Act regulations. The HSE advises that each case is reviewed regularly where a transition closer to home is the will and preference of the individual. These actions are aligned with the principles of the UNCRPD and the HSE’s commitment to equality and human rights. In recognition of the impact that distance can have on people and their loved ones, HSE south west has recently engaged with a private provider to purchase houses in Cork to create capacity in order for people to be repatriated to their home county and create additional new placements. HSE mid-west also confirms it is endeavouring to offer individuals the option of living in residential services closer to their communities through capacity building.

I thank the Minister of State for her response. It is very concerning to hear of the rapidly increasing investment by her Department in privately outsourced residential services for people with disabilities. In many cases a person will move into such a service in the context of a crisis. The HSE will be under pressure to find any place for the person. The residential service they are offered will quite likely be located extremely far from home and sometimes in quite an isolated setting that is not joined up to community or other supports that would allow a person to grow towards increasing independence, connection and integration. We have a scenario where very wealthy private companies are amassing large sums of money with which they are building up significant property portfolios while section 38 and 39 services are struggling to keep the lights on and sometimes paying rent on properties. This is a disjointed, costly and reactive way to provide these services. When will the Government devise a national disability service plan that is implemented through multiannual funding and when will it move away from private outsourcing, which comes with such a human cost to the person with a disability as well as such a financial cost to the State?

I thank the Deputy. While the chief inspector of social services within HIQA does not have the remit to look at the specific issue of an individual’s distance from their original home, where inspectors see that residents are away from their support network or having to travel extended distances to their family, work or school, it is addressed in inspection reports under regulation 9 on residents’ rights and regulation 13 on general welfare and development. On private and not-for-profit providers, the proportion of residential placements for people with disabilities provided by for-profit providers has increased in recent years. This has been in response to demand for new residential places. We have 1,402 residential placements being provided by private providers. This constitutes 15% of the total of all placements and represents an increase of 3% since December 2023, so while it is rising it is rising at 3% over two years.

I thank the Minister of State. The Minister said in a recent budget Estimate session that she wants to move away from private outsourcing but the proportion of money the Department is spending on these services has nearly doubled over the past four years. While the Minister is saying one thing, her Department's actions are the opposite. I can understand the ongoing reliance on these providers but this will not change as long as the Department is devoid of a plan for residential, vocational and community support services that are integrated with each other in each community. We need a service plan for disability akin to A Vision for Change. That document had key staffing targets per mental health service and per head of population. We have a very haphazard pattern of disability services in different areas based, essentially, on a tradition of the service being in that territory. When is the Department going to provide data - even general data - on the distance between a disabled person's house and their community of origin? This is a human rights issue and data on it should be recorded.

On data, I wish to be clear that the cost of care is completely dependent on the level of complexity and the support required. It is imperative to note that as a result, cost is not a reflection of performance and rather is indicative of individualised care needs. What is most important here is the person with the care need at the heart of this. The Deputy has the data on the average cost of residential places. That data is published and publicly available. The Department of Children, Disability and Equality's spending review 2025 contains this information, which is publicly available on our website. It should be noted these average costs are derived from a relatively small sample of placements from 2024 because there is a relatively small sample of placements in existence.