Number of people waiting for disability services has risen sharply since 2019

HSE acknowledged ‘significant unmet need’, with Sinn Féin calling for ‘massive’ funding increase

The Health Service Executive (HSE) has acknowledged there is “significant unmet need” as new figures show an increase in the number of people waiting for disability services.

The HSE provided the figures to Sinn Féin TD David Cullinane, showing there were 776 people looking for residential services at the end of 2019. The number stood at 1,296 in mid-2023.

In relation to non-residential services – including personal assistance, home support services and day respite services – there were 1,117 people waiting in mid-2019. In mid-2023 the number stood at 2,492.

The “point-in-time” data comes from the HSE’s Disability Support Application Management Tool (DSMAT), which provides a list of people who need supports. A HSE statement said: “Services are allocated on the basis of greatest presenting need and associated risk factors, so it is not a chronological waiting list. Rather, it supports decision-making processes locally around prioritisation of services, subject to budgetary constraints.”


Mr Cullinane said he was “not surprised” by the numbers. He said a Department of Health capacity review “outlined the need to massively increase funding”.

Mr Cullinane said he welcomes the fact that the recent Action Plan for Disability Services 2024-2026 has been published but criticised the lack of a commitment to funding on a multiannual basis.

He said: “The only way that people with disabilities will have any confidence that the services that they need will be delivered is when they see a plan that with multiannual funding ... and additional resources but also that clear targets are set on an annual basis”.

Sinn Féin backed a Yes vote in the defeated referendum on care that would have seen care within the family recognised in the Constitution and the addition of wording saying the State “shall strive to support” it.

Some critics of the wording argued it should have been expanded to also include supporting care in the wider community.

Mr Cullinane said: “ people have spoken in the referendum and it was a very clear and decisive No vote but ... one of the clear messages that was sent from the electorate to the political system is that we have to do more for carers and more for people with disabilities”.

The HSE said it “acknowledges there is significant unmet need currently and the projected changes in the size and age profile of the disability population will add to unmet need over the coming decade.”

It said the new action plan “is designed to provide additional funding for developments that will help build capacity within services, so that the benefits of these funding increases will be felt directly by the service user.”

The Department also acknowledged that the level of demand for specialist disability services “exceeds the level of provision”.

It said: “It is true also that recent budgets have seen significant increases to the specialist disability services budget.

“Budget 2024 provided an unprecedented €2.9 billion to specialist disability services for 2024 across a range of service areas including residential, respite, children’s services, adult day services, personal assistance and home support.”

On Mr Cullinane’s call for multiannual funding it said “no formal mechanism currently exists to provide funding on a multiannual basis”.

The Department offered some examples of the level of services currently on offer including approximately 8,400 residential service placements funded and more than three million home support hours delivered to almost 7,200 people annually.

Meanwhile, separate figures provided to Mr Cullinane by the HSE shows that assessment of need (AON) under the Disability Act for 8,893 children was “overdue” as of the end of 2023.

In the cases of some 6,963 children the wait for assessments – which are to determine if they need disability, health or education supports – was more than three months.

In its response to Mr Cullinane the HSE said approximately €11 million has been allocated to address waiting lists for clinical assessments identified through the assessment of needs process.

It also said the HSE at local level is “using time related savings to source AON assessments from the privately for children” in the order they are registered on the system.

Mr Cullinane said: “We need to increase capacity in the Children’s Disability Network Teams who provide both the assessments and the services.

“We also need to make greater use of private sector capacity to speed up access and reduce waiting lists as we build up public capacity.”

Cormac McQuinn

Cormac McQuinn

Cormac McQuinn is a Political Correspondent at The Irish Times