A Review of Disability Social Care Demand and Capacity Requirements up to 2032 was published in July. About 643,000 people (one in seven) in Ireland have a disability or long-term condition. Over 90% with a disability are supported through general community health and social services, in line with the ‘mainstream first’ approach, underpinned through the Disability Act 2005. (The Act places a legal requirement for public bodies like the HSE to include people with disabilities in their mainstream services.)
Sláintecare (the ten-year programme launched in 2019 to reform Irish health and social care services) envisages a model where the majority of healthcare is provided in the community through integrated primary and social care. Where possible, care will be provided at home. Residential care supported housing or supported community living should be in the community and close to home as far as possible. This shift to more care provision in the community aligns with international trends for healthcare provision and the World Health Organisation health and well-being goals.
The Government currently provides an annual budget of about €2 billion for disability services.
Despite this, the report identifies considerable unmet need for residential accommodation, therapy services, personal assistance, and respite care. Current disability spending in 2032 will need to rise by €550m to meet these needs appropriately.
The report says a shortage of funding following the last economic crash between 2008 and 2013 contributed to significant unmet need in the sector. When combined with new and emerging requirements for services “a level of demand that current resources are not able to match” is created.
The report warns that “despite year-on-year increases in statutory funding, the approach to implementing the disability strategy and policy is financially unsustainable and will, arguably, impede necessary healthcare reforms envisaged under Sláintecare if not addressed”.