Pádraig O'Sullivan (Cork North-Central, Fianna Fail)
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I want to talk to the Minister of State about the Before We Die campaign, a grassroots, family-led campaign across the country. It deals with an issue that we in this country have neglected for too long, that being, not finding appropriate residential places for people with intellectual disabilities. Unfortunately, it took a number of parents in Cork to raise this matter, albeit the main instigator, Tony Murray, was based in Dublin. He started this campaign a number of years ago. I pay tribute to Sinéad, Janet, Linda and Esther, who are central to the Cork campaign.

I do not understand how we have got into this position. Frequently, the House is told that we have massive budget increases for various aspects of disability services. That is true on paper, with over €3 billion now being spent on disability services annually and €2.2 billion of that for residential services, but if you talk to the 350 or so people who were in the Silver Springs hotel this day last week with myself and Deputy Séamus McGrath, you will hear of very little residential support and virtually no respite support. Cork has always been a bit of a black spot in terms of lacking disability services. That was no more evident than when residential support was discussed that night. Three hundred and fifty people packed that room. Some of the people had intellectual disabilities themselves, but many were parents, particularly mothers.

The Before We Die campaign has done its own research. There are 1,500 adults in this country with intellectual disabilities who are living with carers who are aged 70 or older. Of those, 500 or so are living with carers aged 80 or over. I am sure that the Minister of State and Deputy Ó Fearghaíl hear of people in their constituencies needing emergency care and intervention. A case came to me not so long ago where someone living in Cork was offered emergency residential care in Meath. That is what we are doing to these people, sending them hundreds of kilometres away from their families. Many of these parents do not want to make the decision to let their adult children leave them, but because of their ages, they just cannot cope any more. Unfortunately, the State offers the solution - the section 38 organisations in Cork offer it – of going hundreds of kilometres away from home. This is normally done to address an emergency or crisis situation.

We have done no forward planning in the last five or six years. The most recent figures made available to us show that 43 residential places were provided nationally in 2023. The waiting list speaks for itself. There are thousands of people in this situation and we are doing nothing to address it.

Since I became involved with the Before We Die campaign in Cork, we have been able to arrange a number of meetings with Cork City Council and Cork County Council and we are doing things locally that are going to help improve people’s lives. The councils have each agreed to appoint a liaison officer to deal with families in these situations. Hopefully, the councils are now going to streamline the application process for social housing for these families.

We cannot forget that the section 38 and section 39 service providers have an obligation. Many have the capacity of housing bodies and can themselves deliver housing. We cannot let them shirk their responsibility.

What is the Department’s view on the Before We Die campaign? What interaction is it having with the campaign? What does it intend to do to solve this residential crisis?

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I thank the Deputy very much. I acknowledge the incredible work he does on rare diseases campaigning. The issue the Before We Die group campaigns on is another incredibly important one. The Minister of State, Deputy Higgins, had hoped to be here but unfortunately she was not able to be. She acknowledges the great work the Deputy is doing and his raising of this important issue.

The Minister, Deputy Foley, recently met the Before We Die group and it is her understanding that An Taoiseach and the Minister of State with responsibility for disabilities, Deputy Higgins, also met it, alongside HSE representatives. The Minister wishes to acknowledge the ongoing commitment and dedication of all involved with the Before We Die group. The Minister also wants to recognise their advocacy for increased residential service provision for people with disabilities and their efforts to shine a light on the very real challenges many of these parents and families continue to face.

The next piece of my speech is going to speak to what the Deputy addressed about the investment that is there. It is just so sad to hear that, when you meet those groups, their lived reality is something very different. The information from the Department tells us that, in 2026, €65 million has been allocated to disability residential services for new developments, which includes €40 million that will provide in the region of 199 residential responses, including 152 residential placements. The remaining €25 million will support in the region of 40 residential packages for children in care with complex needs, the enhancement of existing residential placements, decongregation transitions and the under-65s programme. The Department is working closely with the HSE to move from crisis-led residential placements towards a more planned and balanced approach, with HSE regions and voluntary providers identifying and prioritising individuals earlier to help prevent crisis situations.

The HSE National Service Plan 2026 places greater emphasis on longer term planning for residential placements, with stronger operational processes to respond to the high demand. HSE disability programme leads are developing a procurement framework for residential placements with for-profit agencies, which will focus on purchasing placements on a group basis with the aim of securing more cost-effective placements. The procurement framework is expected to be in place by quarter 2 of 2026. In addition, new HSE housing co-ordinators and residential planning and review teams will be in place this year to co-ordinate and oversee the delivery of the new residential placements and plan for future placements, many of which will be delivered in local authority homes.

The Ministers, Deputies Foley and James Browne, with their officials, have made significant progress through the implementation structures established under the national housing strategy for disabled people in improving co-ordination with the local authorities and disability service providers at local, regional and national levels. This includes establishing the levels of unmet need for specialist disability residential services in each county or local authority area. This will inform the setting of targets in the local authority housing development action plans for two cohorts of disabled people, namely, those living more independently in the community and those with greater support needs, who will receive specialist disability residential services. Some €25 million in new development funding for respite services in budget 2026 has afforded the HSE the opportunity to plan for the expansion of services, with a range of respite initiatives under way. The HSE national service plan targets the delivery of 10,000 additional respite overnight sessions and 25,000 additional respite day sessions this year.

I will come back with a little more information later.

Pádraig O'Sullivan (Cork North-Central, Fianna Fail)
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I thank the Minister and welcome the initiatives. I spoke to the Ministers, Deputies Foley and Browne, in recent weeks and I knew that a plan was coming together. However, as many Deputies will know, I am a cynic in here. I do not understand how we are having this discussion in 2026 and how no one in the various Departments, but particularly the Department of disabilities, had a light bulb go off at some stage and realise that the Departments were not meeting the level of need. As the Minister of State read out from the speech she was given, there is an unmet need. We all know it. I will give the Minister of State an idea of the numbers. In June 2025, 1,389 people were awaiting residential placement. That was up from 776 in 2019, a 79% increase in five or six years. Did no one in the various Departments not realise there was a problem, given the nearly 100% increase in the demand for residential places? I do not even have time to discuss respite support.

It is welcome that the Ministers are getting together and that a plan is going to be in place, but it takes time to build these houses and deliver these units. If the plan started this year, it would be a couple of years before we saw those units being turned over. The budget allocation will provide for nearly 200 places, but in 2023, only 43 new residential places were provided in the entire country. It was a pitiful amount. What these people are asking for is their right, as they all have a right to housing. Some of them are well capable of living independently. Some require round-the-clock care. It is that diverse a cohort.

There are two matters I will mention that I would like the Minister of State to take back to the Minister, the first of which is decongregation.

I understand why we did it, but if you talk to the parents who have children with intellectual disabilities, including adult children, they will say that they want a setting where they feel their daughters or sons can be safe. Some of them want to live in a gated community, and some want to be surrounded by the elderly. Locking these people away in apartment blocks is not the right way, just for the sake of decongregation. We need to have a proper debate about this.

Cork city and county councils have delivered their targets of 20% for people with disabilities. However, it is important that we distinguish between people with physical disabilities and intellectual disabilities in counting those numbers.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I again thank the Deputy for raising this important issue, which is a priority for the Ministers, Deputies Foley and Browne, and the wider Government. The Government recognises that there is more to do to improve the lived experience of those with disabilities. The increase in the disability budget for 2026 further demonstrates the multiple commitments made in the programme for Government to improve the lives of people with disabilities and make a difference. The Minister, Deputy Foley, 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 the services provided. The ambition of the Government is to bring about a step change in services for people with disabilities in Ireland. It is committed to the expansion and reform of disability services to maximise people's independence and their health supports to help them to live ordinary lives in ordinary places.

The Minister wishes to reassure the Deputy that the Government is aware of the challenges presented across all regions. The Department is actively engaging with the Department of housing and the HSE to increase service provision, to support service providers to carry out their vital work and to explore various ways of responding to demand.

I have taken note of the specific issues the Deputy has raised and I will relay them to the Minister, Deputy Foley.