Eoghan Kenny (Cork North-Central, Labour)
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As regards the Minister of State who has just left the House, Kieran O'Donnell, it would be remiss of me when speaking on an issue like this not to commend his father, Martin, one of the founding members of St. Joseph's Foundation, and his commitment to disability services in north Cork.

This morning I raise a serious issue regarding residential placements for adults with disabilities. I want to speak specifically about the Cork and Kerry region. The programme for Government states:

After reviewing the recent two-year healthcare funding agreement, we will consider the development of a multi-annual approach for disability services, which will be linked to productivity, staff levels and the delivery of services.

While I appreciate that it might not be in her script, may I ask the Minister of State about the approach being considered? Why is the word "consider" used in this part of the programme for Government, considering, ironically, the level of need within both our service and our system? Will she clarify if the Government is still considering the development of the multi-annual funding approach or can she provide a guarantee to me and families right across the country right now that this Government will commit to an multi-annual funding approach? In Cork and Kerry, there are 600 people waiting for residential placements. The answer to a parliamentary question that I received from the HSE stated that many of those 600 will benefit should the Government allocate multi-annual funding to HSE south west to address the deficit in the quantum of residential places. To me, that basically means the HSE is waiting for the money. As a result, it once again falls to the Minister of State's Department and the Government to decide whether these services for these families and adults will be provided.

In budget 2025, €106.6 million was allocated towards residential places. However, only €27.9 million of that remains because of the €78 million needed to meet the incremental costs from 2024. I accept that increases in age and life expectancy and the changing needs of people with a disability have led to the need for increased residential facilities. Does the Minister of State agree, however, that we are not doing enough at a quick enough pace to meet the demand? It comes back to political will. There is no will to commit to funding residential placements at a far higher figure than the current ones. I welcome the fact that in four years there has been an increase in 559 residential placements. However, as I said, this is simply not good enough or quick enough. Residential capacity will decrease during the year as a result of the loss of places in congregated settings due to debts which cannot be reutilised. I understand that this is in line with Government policy, which is to move away from institutionalised settings. While I agree with Government policy in this regard, with the closing of placements, this will only place more pressure on the HSE and not-for-profit organisations to try to relocate placements for those on waiting lists. Along with this, in addition to the issue, the in-year capacity levels will be impacted negatively as a result of regulatory requirements. No placement across this State should be closed until another one is opened. That is my firm belief.

We must also recognise services like the Brothers of Charity in my constituency of Cork North-Central that have done such wonderful work in many areas of my home county. I have an uncle who has been working in the Brothers of Charity, Lota More, for more than 20 years. I have seen at first hand the care and commitment to the development of these adults with disabilities, which must be recognised.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Deputy for raising this important issue and for offering me the opportunity to respond.

The Minister knows that there are many reasons why people seek residential supports. For some, it is by way of services to allow them remain in their own homes with family. For others, it is a residential service. The aim has been to facilitate living and inclusion in the community.

Increasing the provision of disability residential services is a key priority area for this Government and the HSE, and there has been significant investment in residential services over recent years. In July 2023, the Government approved the disability action plan in order to address capacity deficits which had been identified in the disability capacity review. From this, the action plan for disability services was developed, providing a multi-year framework for service expansion and strategic policy development with a view to maximising effectiveness and impact. The action plan has informed budget deliberations and the prioritisation of areas for development in the coming years. It is a living document which will be reviewed and updated in the light of priorities, policy considerations and the funding available under the current and subsequent budgets.

Unlike the position for capital expenditure, where multi-annual commitments are made within the national development plan, my Department is obliged to adhere to the public sector financial procedures, whereby Exchequer funding for current expenditure is allocated on an annual basis, following the annual budgetary process. As a result, it is not currently possible to enter into multi-annual funding agreements for disability residential services.

Although multi-annual funding is not available, the Minister wishes to reiterate that this Government is committed to providing support to people with disabilities and significant investment has been provided to specialist disability services, including a budget increase from €1.7 billion at the close of 2017 to over €3.2 billion in 2025. Supporting residential services accounts for approximately 60% of the total specialist community-based disability services budget.

Some €106 million in additional funding has been provided to residential services in budget 2025. This includes €78.68 million to meet the incremental cost of 2024 new developments and €27.9 million in new funding in respect of 2025. This funding also supports additional moves from nursing homes and decongregation to community settings. In recent years, the number of residential places delivered has exceeded what has been initially envisaged in the HSE national service plan. In 2024, 220 new residential places were delivered.

I see all the great work that is done out there. I know we need to do more but it is a commitment in the Government to work with all the different services.

Eoghan Kenny (Cork North-Central, Labour)
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I appreciate that. As regards the 2021 disability capacity review to which the Minister of State referred and the projected need for a minimum of 1,900 residential placements by 2032, which we want to get to, and if we continue in the same vein of the previous four years, which is not mentioned in the response, with 140 placements opening each year, give or take, there will be 400 fewer than the figure. The same disability capacity review asked for an extra 3,900 placements needed to return to pre-2008 levels. This is shocking. For someone new to this House, it seems we are going backwards. This is political will, or the lack thereof.

It is not the same for many families and their sons or daughters. One family has been in contact with me. I have known this family all my life. I grew up with them and their sons, one of whom has a disability and needs access to residential placement. The place he is in for day services is something he and his family have fallen in love with. This gives great comfort to his family and his parents in particular. However, they cannot get a commitment as to whether or not he will have a residential placement should, God forbid, anything happen to either of them. They continue to fight long and hard for residential commitment or placement for him but to no avail. This is not the Ireland we want, and I know the Minister of State would agree with me on that. Having tried so hard to even get a meeting with senior management in the disability team of the HSE, they came out of that meeting two weeks ago with still no guarantee as to what will happen to their son. This family does not want sympathy or empathy; they want a firm commitment. However, that cannot be provided to them. When they make contact with me, they should be given the commitment. However, I cannot because I do not see a genuine commitment from the Government.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I understand the challenges. I know there is significant demand for residential placements at a level which consistently exceeds supply.

We are living longer and we need to do more. I can assure the Deputy that the Government is committed to funding and to working on this. Challenges in providing these services include workforce challenges that apply to all specialist disability services, the acquisition of suitable housing stock and the increasing cost of providing residential care. Regulatory compliance is important in residential services and HIQA continues to inspect all designated centres for people with disabilities. This is critical to providing assurances that the quality of life of those living in residential services is appropriately addressed. In order to address these challenges, the Department of Children, Disability and Equality continues to engage with the HSE, Department of housing, and other relevant stakeholders to explore various ways of responding to demand while appropriately managing the significant levels of funding provided to residential services. Finally, the Minister would like to reiterate the importance of ensuring that we continue to support people with disabilities to live meaningful and fulfilling lives, with a person-centred approach across all services provided. I can see the Deputy's commitment and dedication and I want to thank everyone involved for the work they do. I thank the Deputy for bringing this to the House today.