Rory Hearne (Dublin North-West, Social Democrats)
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Táim anseo today to speak about an issue related to disability services in my constituency but which affects the wider Dublin area and the country. I will speak about St. Michael's House and about a constituent whose issue I have raised and want to raise again today. St. Michael's House on the Ballymun Road provides a range of services and supports for people with disabilities and their families, from residential supports and independent living to clinical support, day supports and respite. St. Michael's House is also a lead agency for the Dublin CDNT, which supports thousands of children and also has a waiting list for day services.

I want to talk about residential services for older service users. There is currently a residential waiting list for 55 individuals: eight are aged 66 and over, 22 are aged 46 to 65, 15 are aged 31 to 45 and ten are aged 18 to 30. Forty of these individuals are classified as high risk, highlighting the urgent need for placements and increased resources to provide care for them. Unfortunately, due to resource constraints, St. Michael's House placed a pause on new additions to the residential waiting list from 14 March this year.

An issue facing families across the country and my constituency concerns children who are now adults and who have disabilities. Their families are deeply concerned about what will happen when the parents pass away. Who will care for their children? There are also those who do not have the capacity to provide care for their children any more because they have got too old or the needs have increased to the point that it is not sustainable for them to continue to provide care in the home. As I have outlined, there are significant waiting lists.

I have been contacted by the parents of a woman - their youngest child - who is 32 years of age.

She has Down’s syndrome and associated medical and health issues. As well as Down’s syndrome, she has a visual impairment, mobility and balance issues, sleep apnoea, for which she uses a machine, and speech and language difficulties. She attends a St. Michael’s House day service from 9.30 a.m. to 3 p.m. She really enjoys going and participating in the various activities but there are no respite or social supports outside of this for her parents, who are now in their 70s. They are physically, emotionally and mentally exhausted. Their enduring worry is what will happen to her when they die. There are no residential places available for her. The Minister of State can think about that emotional and mental exhaustion of parents in that situation, who are concerned about what will happen to their child when they pass on. Where will she be minded? Who will look after her?

Services like St. Michael’s House are struggling to keep up with demand for respite and residential care, which is leaving families in unimaginable and unsustainable situations as they worry about what will happen to their adult children. Between hospital staffing costs, operation costs and, crucially, the lack of multi-annual funding, they are projecting a funding deficit for 2025. If the Minister of State can give me a response to these questions, I would appreciate it.

Alan Dillon (Mayo, Fine Gael)
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I thank Deputy Hearne for raising this important issue and for offering me the opportunity to respond on behalf of the Minister, Deputy Carroll MacNeill, who is not here today.

Increasing the provision of disability residential services is a key priority for the Government and the HSE. All Deputies across the House will have specific cases relating to the many families who are finding challenges in this regard. There has been significant investment in residential services throughout the tenure of this Government. We are very aware of the need for increased service provision within the disability sector. In acknowledgement of this, the programme for Government commits to tackling waiting lists for specialist disability services by progressively implementing the action plan for disability services out to 2026 and resourcing and delivering on its targets.

In budget 2026, the Government has allocated a record €3.8 billion to disability services, reflecting our commitment to the expansion of services to meet the needs of people with disabilities. This represents an increase of almost 20% year on year and an overall increase of €1.8 billion since 2020. Approximately €2.21 billion of the funding secured will enable the Department to deliver residential services for over 9,000 disabled people, enabling them to live as independently as possible in their local communities. In 2026, this means continued support for people currently accessing residential services and an additional €65 million to support the delivery of additional residential responses and supports for adults and children with disabilities. Residential service delivery expectations will be confirmed in the coming weeks in the forthcoming HSE national service plan for 2026.

The Deputy raised a specific case in St. Michael's House. It is a pivotal provider of disability support, particularly much-needed residential supports. I am informed by the HSE that the organisation provides residential supports to 410 adults and a small number of children with disabilities across 79 centres, mostly in Dublin and the wider Leinster area. It is the intention of this Government to continue to support organisations such as St. Michael's House to provide specialist disability supports to those who require them and to continue to support people with disabilities to live meaningful and fulfilling lives, with a person-centred approach across all services provided.

The Deputy will be aware that the significant demand for specialist disability services across all regional health areas nationally exceeds what can currently be provided. This is reflective of the additional 20% budget that has been provided. While the Department is working alongside the HSE to move towards more planned provision in residential services, the nature and level of demand is such that the placements delivered tend to be in response to shorter term priority needs. It is important to recognise that the HSE faces significant challenges with regard to increasing the provision of residential placements, namely, the availability of suitable housing, staffing, the increasing cost of providing residential care, the changing needs of service users and regulation.

In order to address these challenges, the Department of Children, Disability and Equality continues to engage with the Department of housing, as well as the HSE, to explore various ways of responding to demand to provide suitable living solutions that give people with disabilities greater independence and choice in their daily lives.

Rory Hearne (Dublin North-West, Social Democrats)
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Gabhaim buíochas leis an Aire Stáit but that is an inadequate response. He acknowledged that the HSE is facing significant challenges in the provision of residential placements and in the availability of suitable housing and staffing, as well as the increasing costs of providing residential care and the changing needs of service users. He has outlined the challenge, but we need to see solutions. While there is an increase in funding, it is clearly not enough and that is the issue. What about families like the one in the case I raised, where the parents of a child of 32 years of age with Down’s syndrome, who are in their 70s, are absolutely terrified about her future and where she will go? We have a significant waiting list for people, eight of them, as I said, over 66 years, and 22 aged between 46 and 65 years. These are high-risk situations. We need a much more considered and significant funding response that addresses these challenges. We cannot just let them go on. People who have disabilities have every right to a decent standard of living, an independent life and supported housing and to be able to live a quality life like anybody else, but as disabled people explain over and over, along with their carers and families, that is not the situation. Yes, the Government is dealing with and responding to decades and decades - indeed, since the foundation of the State - of inadequate support for people with disabilities, but we have to get it right now. We have to provide that republic of equality, particularly for disabled people. We need extra effort for cases like these and services like St. Michael’s House to ensure people with disabilities have that quality of life, and so their families do too. I ask the Government to do more on that.

Alan Dillon (Mayo, Fine Gael)
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Again, I agree with the Deputy. I think we are all in agreement that we do need to commit to tackling the waiting lists. That is why we have a dedicated Minister of State with responsibility for disability at the Cabinet, working within the Department of Children, Disability and Equality, as part of the wider Government response to increase the number of residential places and improve capacity within the sector as a whole. The action plan for disability services out to 2026 is designed to provide additional funding but also to help build capacity within the services and meet the future needs around residential placements through the provision of over 900 residential care places to tackle not just the current need but also the unmet need, and also to ensure that supply keeps pace with demand because while one bed may be filled this week, another bed may be required next week.

We have seen progress in 2024. Last year, over 220 new additional residential places were delivered. As of August this year, we had over 142 new residential places. In the most recent budget, an allocation of over €65 million in additional funding was secured for additional disability residential responses. That will be set out in the HSE’s national service plan for 2026. We want to continue to support the likes of St. Michael’s House. Over 1,200 services are being funded by HSE Dublin north county and Dublin city and west, including many in the Deputy’s constituency. I assure him that the Department is working alongside service providers such as St. Michael’s House and the HSE to address these challenges and to support providers right across the country to carry out the vital work they do in the delivery of services to those with a disability.