We have not received any apologies, which is great. The meeting has been convened to consider the Supplementary Estimates for Vote 40 - Disability. I remind members that the remit of this select committee permits for the consideration of the disability element of the Supplementary Estimates only.

Before we begin, I will read a note on privilege and some housekeeping matters. All witnesses are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative that they comply with any such direction.

The evidence of witnesses who are physically present or who give evidence from within the parliamentary precincts is protected, pursuant to both the Constitution and statute, by absolute privilege.

I remind members of the constitutional requirement that in order to participate in public meetings they must be physically present within the confines of the Leinster House complex. Members of the committee attending remotely must do so from within the precincts of Leinster House.

I thank the Minister, Deputy Foley, the Minister of State, Deputy Higgins, and their officials for attending the meeting. I invite them to make their opening statements.

I thank the Chair very much. I thank the committee for making time available this evening to consider this Supplementary Estimate for specialist disability services funded through the Department of Children, Disability and Equality. The Department is seeking a Supplementary Estimate across the wider Vote, principally due to cost pressures associated with the demand for services being provided by the HSE disability services and Tusla. These cost pressures require an upward adjustment to the Department’s total Vote allocation for 2025. In summary, cost overruns of €329.6 million are forecast for this year. Savings of €115.9 million are also forecast across various subheads. The overall value of the Supplementary Estimate is, therefore, set at €213.7 million.

I attended the Select Committee on Children and Equality yesterday evening to discuss the elements of the Supplementary Estimate which relate to other parts of the Vote. For this committee meeting, I will focus on HSE disability services. I will now turn to the key components of the forecasted Supplementary Estimate.

It is forecasted that specialist disability services will require €267 million in supplementary funding in 2025. The main components of the overspend include €85 million for specialist residential services; €48 million directly associated with other service areas, including children’s services, respite, day services, home support and personal assistance, PA; agency staff costs require €54 million in supplementary funding; and in the region of €60 million is required to support service provision with additional costs, including inflation, overheads, maintenance, etc.

The largest part of the disability supplementary requirement relates to residential services and is primarily due to demand for residential places outstripping the funding available. The additional funding required will ensure that places for over 600 people who needed a residential service between 2023 and 2025 are fully funded. The requirement is also driven by the cost of agency workers needed when demand for service provision exceeds the available workforce. In addition, challenges around recruitment and retention are resulting in a reliance on agency staff and overtime to maintain service provision. Costs associated with respite, day services, home support, personal assistance hours and children's services are also included. These relate to situations where activity has exceeded funding available or where costs have increased.

The committee will be aware that I secured a very substantial uplift in funding for disability services in budget 2026, with a total of €3.8 billion allocated to the sector next year. The additional funding in 2026 includes a significant existing level of service provision of €468 million to address sectoral funding pressures. Through this Supplementary Estimate, I am providing the additional funding required to meet the costs in 2025. Through budget 2026, I have ensured that those costs are also covered within the allocation for next year. It is intended that this Supplementary Estimate and the funding allocation for 2026 will, when combined, help to stabilise the sector and bring certainty to service providers in relation to their funding. In addition, €150 million was provided in the budget to fund service expansion in residential and respite services, day service provision and increased investment in home support and personal assistance programmes.

It will also support continued strong recruitment of in the region of 1,000 staff in line with trends in 2025.

In recognition of the very significant investment of almost €4 billion being made in the sector in 2026 and the need to manage within the parameters set out in the budget, strengthened oversight and governance arrangements have been agreed with the HSE and will be implemented next year.

While the supplementary funding being sought relates to specialist disability services, I will take a moment to comment on the Department’s wider remit in relation to disability equality matters. Members will be aware that on 3 September this year, the Government launched the national human rights strategy for disabled people. This is a landmark strategy, the first published since Ireland ratified the United Nations Convention on the Rights of Persons with Disabilities. It provides a framework for collaboration across government to deliver on our obligations under that treaty. Crucially, the strategy will be delivered across five pillars. The scope of ambition of the strategy fulfils the Government’s commitment to progressively realising Ireland's implementation of the United Nations Convention on the Rights of Persons with Disabilities in ways that will have the maximum benefit for disabled people. Budget funding is essential in supporting us to achieve our aims.

I recommend this Supplementary Estimate for Children, Disability and Equality - Vote 40. I am happy to address any questions members may have.

Having spent four years as a member of the Committee on Disability Matters, I am delighted to have the opportunity to attend today in my new role as Minister of State with responsibility for disability. I look forward to working with the committee, alongside the Minister, Deputy Foley, to ensure that the important policy and budgetary considerations that impact people with disabilities are thoroughly discussed and appropriately scrutinised.

As the Minister set out in her statement, €267 million in supplementary funding is under consideration by the committee today. This will support a range of specialist disability services where activity has exceeded funding targets, as set out in the HSE’s national service plan, or where the cost of delivering services has increased. The Minister has set out some of the key areas that will be supported through this additional funding.

To expand on that, specific examples can be seen in the areas of personal assistance and home support, where €11 million is needed to meet the cost of hours provided in the current and previous years that exceeded the national service plan targets, with home support packages being a key driver of this increased activity. In the area of day services, an additional €11 million will be allocated to address additional costs arising through those services. This includes costs associated with providing transport for people with disabilities to and from day services.

While the provision of transport services is not part of the core service within the HSE specialist disability service, we recognise that viable public transport options were not always possible or available throughout the country and that transport support needs vary between individuals. In some instances, transport supports were provided by the HSE or funded through agencies on a discretionary basis, and a variety of transport solutions were pursued in different health regions. These include travel training to enable public transport to be used, where appropriate, local transport such as Local Link, private transport and some service providers provide transport where capacity exists.

It is important to note that this supplementary funding will also help to address the financial challenges being experienced by many of the section 38 and 39 organisations that provide specialist services on behalf of the State. It is vital that we support these organisations, which are reporting significant financial challenges. The financial challenges facing the voluntary sector are highly complex, arising from both historical issues around funding arrangements as well as emerging challenges due to the changing profile of user needs, higher safety and quality standards and general demographic pressures. We are committed to working with the HSE and the broader disability sector to better understand costs and the drivers of those costs to ensure we can maximise the impact for the service user from the significant level of funding being invested in the sector.

The Minister referenced the significant investment in disability services committed through budget 2026, with an additional €618 million being invested. That represents a 20% increase on 2025. A key focus next year will be on ensuring the budget meets the real cost of service, ensuring a stable base upon which to plan and expand services both now and into the future. The aim is to provide stability for a sector which has seen significant cost increases in recent years on top of a rising demand for services.

In addition to the areas outlined by the Minister, the additional funding in 2026 will provide for an extra 1,400 day service places for school leavers. Budget 2026 will, for the first time ever, enable a cohort of in the region of 50 older adults to avail of day services. Day services are ordinarily offered to school leavers or those leaving rehabilitation training, so this is a new departure. It is important as it gives people options later in life and as their circumstances and wishes may change. This includes people who may acquire a disability.

There will also be a significant expansion of both home support and personal assistance service hours. Precise numbers will be set out in the HSE’s national service plan. As well as expanding services, we will also look at a new vision and strategy for disability services, in line with commitments under the national human rights strategy for disabled people. This will allow us to take a deeper look at the service model and work to make services more person-centred.

I echo the Minister's recommendation of the Supplementary Estimate for Children, Disability and Equality - Vote 40. I am very happy to address any questions members may have.

I thank the Minister of State. The committee has been circulated with a document providing details of the Supplementary Estimate for disability. The secretariat has also prepared a briefing setting out details of the Supplementary Estimate in tabular form for the Vote. I remind members that in accordance with Standing Orders, discussions should be confined to the items constituting the Supplementary Estimate, specifically disability.

I now invite members of the committee to contribute. When I call members to speak, they should adhere to the agenda item scheduled for discussion. Members have seven minutes and when one has finished, we will move on to the next speaker. The first speaker is from Fianna Fáil. Deputy Martin Daly has seven minutes.

I thank the Minister, Deputy Foley, and the Minister of State, Deputy Higgins, for coming here with their teams from the Department this evening. The whole disability area is huge and it has been prioritised by Government. It is an area where there is a huge and growing need. At the end of the day, we need to be sure we have adequate funding going forward for the development of new services but also that we get value for money. That is on everyone's minds.

Looking at the Supplementary Estimate statement, I will refer to the €85 million overspend for specialist residential services. Are those residential services provided directly by the State or are they third-party, private providers?

It is a combination. I concede that it is a significant overspend but it is necessary. It is to ensure that people are appropriately cared for in appropriate settings. With regard to residential as a whole, more than 60%, or approximately €2.2 billion, of the entire disability budget is spent on residential services. In 2026, it will deliver services for 9,000 people. An additional €65 million is being provided in 2026 to deliver supports to ensure there will be new residential places, take appropriate measures for the under-65s who are in nursing homes and provide enhancements and upgrades in existing residential service. We are hugely committed. On the overspend we have this year, we went through a protracted budgetary process which provided €618 million in additional funding. This puts us on a much steadier footing for next year, not just for residential services but in the round.

With regard to value for money in the publicly provided system and among the private providers, are the costs like for like or does the Department pay a good deal more for the private providers?

It depends on the complexity of the individual. It is very clear that one size does not fit all, nor would I expect it to. In some instances, 24-hour care will be required. It will be less for another individual and then less again for another individual. I do want to say-----

I am sorry to interrupt, Minister, but a vote has been called in the Dáil. We will have to adjourn. Is that agreed? Agreed.

Are we adjourning?

We will suspend, gabh mo leithscéal. There is a very important difference. We will suspend the meeting until the vote is over.

The cost of agency staff caught my eye. My view on agency staff is that we should be planning for a more permanent service and permanent staff and we should try to recruit and retain staff in the service to build up continuity of care. There is also the cost of agency staff. I mean no disrespect to individual agency staff who do a good job and are needed.

I do not disagree. The Deputy will have seen the figure of €54 million. There is an agency conversion proposal being discussed with the Department of public expenditure at this point. I think that would serve us well.

There are extraordinary demands in terms of having a safe level of staffing, HIQA standards and complex cases, as I referenced earlier, some of which require 24-hour care or whatever. We are determined to do better in this area going forward. I am hopeful of those conversation opportunities, with the support of the Department of public expenditure.

It seems we are not spending money on recruitment. We are not recruiting staff, so there is an underspend on permanent staff. That appears to be the case from the figures.

Will the Minister comment on the underspend on the mother and baby institutions payments scheme?

That comes from yesterday.

I am sorry.

The uptake has not been at the numbers we anticipated in the early years but people have until March 2029 to come forward. We are doing huge advertising and promotion campaigns to encourage people to come forward. We want people to come forward and draw down what is their due. We will continue to advocate in that space as well.

The figure caught my eye. I thank the Minister for answering my question.

It is part of the entire Vote.

The Minister mentioned the provision of 1,400 additional respite places next year under the new funding. One of the big challenges is how we manage the transition from secondary education to beyond education. There is also the transition for older parents, which is an issue I have mentioned before.

I agree.

Older parents looking towards the end of their lives are really worried about what will happen to their offspring who will need full-time care.

Again, I agree with the Deputy. There is an emphasis in the provisions being made in our budget for 2026 for planned resourcing. Obviously we know at a very early stage that in the case of a person who is being cared for at home, it often gets to a crisis point when the parents reach 80 or 90 years of age or whatever because they want to keep-----

We need actions.

-----their young person at home. We are putting particular emphasis, as I mentioned, on residential services. We have a significant capital fund of €43 million, which is a 60% increase on previous years. We are also working, from the point of view of housing, with the Department of Housing, Local Government and Heritage, on what it can produce for us. We are working to ensure we have the places available on time for those who need them. There are earlier and earlier starts to do that. We are coming from a low base, so it will take us quite some time. We launched the national human rights strategy for disabled people not long ago. All of that is in the strategy. We have given a commitment to take the necessary steps over the lifetime of the Government. The budgetary funding we are receiving, particularly for 2026, will help us along that way.

I thank the Minister, the Minister of State and their departmental colleagues for being here this evening.

The Minister mentioned the national human rights strategy for disabled people. The strategy is impressive rhetorically but lacked details on funding and timeframes. My understanding is that the first action plan connected with the strategy was due to be published in November.

No, that is not correct.

The action plan for the strategy is very much where it is at. When will we see the first action plan?

In actual fact, the action plan was meant to be three months after the launch. I said on the day, and have continued to say, that the implementation will be chaired by the Taoiseach. The various subgroups will include disabled people, who will be part of the general oversight as well. The implementation group will meet in December under the Office of the Taoiseach.

Will the action plan be published in December?

Yes.

Very good. I have very serious concerns about the degree to which this Government and the previous Government have privatised disability services and how that trend appears to be increasing. There are very clear adverse outcomes for people attending services associated with this trend. In the case of residential services for people with an intellectual disability, I am hearing of people being offered a bed, more often than not, during a crisis. I say "offered a bed" advisedly because the person is quite likely to be uprooted from his or her community. In some cases, people are placed more than 100 km or even 200 km from home and because this is the first bed made available to them, they are compelled to take it. In some cases, the person is living not only very far from home but in quite an isolated setting without access to community supports, and they can remain stuck in that situation indefinitely.

A recent response I received to a parliamentary question indicated that private for-profit companies are now providing 15% of residential services for people with an intellectual disability. That is almost double the proportion at the end of 2021. My understanding is that these private companies are building up substantial property portfolios because when they are offered the substantial funding they receive from the Department to accommodate service users, they are financially able to buy a property. Meanwhile, section 38 services are often left renting properties for their services. How much funding does the Minister intend to invest this year in private for-profit residential services for people with an intellectual disability? How much will be invested in adult services versus child services?

In the main, there has been a reliance on private providers to meet emergency needs, in particular, in the past. I am not happy with that but I have visited many of the private providers and other providers and I do not want to denigrate the service being provided. In 2026, a new procurement scheme will be in place for private companies to ensure we get the best possible value.

Does the Minister have the figures for the coming year?

I can share the different figures now with the Deputy and further detail will come. The capital allocation is €43 million, and that will be for a mix of places that we will buy or we will work with providers. We have €65 million in place for residential services.

Is that for private for-profit facilities?

No.

I am specifically interested in that figure.

I do not have that division. It is not available at this point in time.

When will the figure be available?

As I said, we are putting new procurement mechanisms in place. Obviously, we have ongoing engagement with section 38 and 39 organisations. If there is a gap, that gap has to be covered because the service user is a priority.

Why are we not funding section 38 and 39 services to the same degree?

We certainly will be. There is no question.

There is a huge financial cost associated with-----

I have visited very fine section 38 and 39 providers. We are absolutely doing that but where there is an emergency need-----

The emergency need turns into a long-term situation. That is the problem.

I have already said that we are looking at ways of doing planning at an earlier stage and ensuring we have a better targeted provision put in place. We needed a significant uplift in our budget to do that. We have over €500 million in additional funding - €618 million, to be exact - going into disability. All of that will allow us to have a variety of different levers to address many of the issues raised by the Deputy.

It is not about the increase in budget but if the proportion of the budget that is going into private for-profit companies is increasing, that is very problematic.

No, it is also about the capacity of section 38 and 39 organisations to deliver at a particular time.

Capacity is based on funding and investment.

I am saying that where they can do it and where they can step forward, they will be funded to do it, and they are currently being funded. We will be engaging all the more with them.

Not according to clinicians I know who are working in those services.

To be fair, I have visited many excellent providers that fall into that category and are willing to step forward, depending on the availability, and earlier availability, of funding. Another reason for getting this uplift in funding is so that we have earlier certainty of availability of funding.

I am conscious of time. I have asked the Minister in parliamentary questions to provide information on the number of service users who are living more than 100 km from home in private for-profit settings. The Department told me in response that it does not keep that information. That is very problematic because if a disabled person is living that kind of distance from home, it is a clear breach of the UN Convention on the Rights of Persons with Disabilities. In many cases, there is no end in sight to that. The dislocation of a person from his or her family and community is a human rights issue. That information should be provided.

I also was not given wait times for people on waiting lists - often languishing on waiting lists - with ageing parents who are unable to cope. We need to know the wait times people are enduring.

I will briefly ask about private outsourcing of assessments of need. How much is the Department investing in that and by how much is last year's spend increasing?

I think we are unanimous around the table here, as we were on the formation of the Government, that disability is coming from a low base and that there is so much that needs to be done to improve the experience of life for those who live with a disability. It is for that reason that disability has been given number one priority by the Government. We have a unit within the Department of the Taoiseach. Never before has such a priority or status been given to disability. We have over €618 million additional resources going in. We have a capital fund that has almost doubled under this budget. I am in full agreement that more needs to be done here but, as I have said, it will have to be done over the lifetime of this Government.

I just hope the Minister takes on the concerns around the deeply problematic trend of privatisation. We have seen in every care group how adverse the outcomes can be.

I welcome the Minister. I also offer my congratulations to our new super junior Minister, which I think is the wrong phrase, on her elevation.

Super junior is good.

It is like going from junior B to junior A hurling, but she is going up the ranks anyway.

And she is super.

I congratulate the Minister of State on her new role.

It is very important to acknowledge the significant investment in disability services in the recent budget. The additional €618 million, a 20% increase on previous years, is coming from a lower base but it shows that the Government is absolutely committed to increasing investment in the disability services. That has to be acknowledged. It is year one of five years in terms of the budget side of things. Disability is in the Department of the Taoiseach and it is very important that is noted.

From my side of the house, will the Minister talk to us about adult day services? When young people leave school they need a safe and engaged place to go during the day. It is a challenge out there. I ask the Minister to elaborate on that a little.

I will say a few words and then the Minister of State might like to come in. There is a significant increase in funding in 2026 for day services, from €24.5 million to approximately €25 million. Some 22,000 people are currently catered for in day services. There will be an additional 1,400 places made available for early school leavers. For the first time, we are making provision to have capacity for older people who might have acquired a disability, a brain injury or whatever. We are starting off with low numbers. The Minister of State may wish to add to that.

The figure last year was a total of 1,388 placements. This coming year, we will be increase that, with 1,400 new placements and 50 non-school leaver placements. That will be at a cost of about €26.1 million. The 50 non-school leaver placements, which the Minister referenced, will be targeted at people who are older and whose circumstances in life might have changed or maybe their minds will have changed and this is something they would like to avail of. There are fantastic providers up and down the country doing immense work in this area. It is good that we are now giving people of all ages the opportunity to link in with those services.

To be fair, the State really is stepping up to help people with disabilities and their families with these extra numbers. I acknowledge the just shy of 1,400 additional spaces, which is absolutely fantastic and a big increase on previous years. I know that is not a topic for today, but I implore the Department to continue that year on year. The service the providers provide is absolutely amazing. I have seen at first-hand, as I am sure everyone has, the impact it has on individuals and their families. It is a great start and a great acknowledgement but I ask that the Minister keep the foot on the pedal in terms of continuing to try to get extra places.

The Deputy will see tomorrow, when the Minister launches her new sectoral plan, that we are talking about sustained increases over the next number of years from a capital perspective. We also hope we can negotiate increases in current expenditure too.

While I acknowledge the significant increase in funding, the most topical conversations I have with people in the disability sector and their families relate to respite. They are at their wits' end in a lot of cases. Some of them are going above and beyond what any normal human being would be able to do. I have seen it at first-hand and it is absolutely amazing. Will the Minister talk about the increase to the respite budget for 2026. What will that achieve? What will be the benefits in terms of respite for families who are struggling?

The Deputy is correct that respite is probably the issue that is most frequently raised with me. Obviously, residential care is also raised but respite is very close to that. In 2025, 164,000 additional nights were being provided for and 65,000 day respite opportunities. That was an 82% increase since 2019. In budget 2026, an additional 25,000 day respite opportunities will be provided for and 10,000 respite nights. I also know that for a lot of people, it is about the nights as much as it is about the days. It is important to note that we have the opportunity for day respite too but the crucial thing for a lot of people is the night respite opportunity.

I have visited a number of different providers, most recently in Ennis. Based on the funding we have now, I was able to announce that we would increase overnight respite opportunities from 700 to 1,400. I cannot tell the Deputy the difference this has made to the parents I met. It was significant and I would like to think we will be in a position across the country to do that more and more. Again, we will not be able to do this by magic but when people see that we are making these incremental changes in various places, it will allow us, almost like a domino effect, to do more in other spaces as well.

I also want to acknowledge the home-sharing opportunity that has been provided for. This is where people genuinely open up their homes and provide respite for an individual who needs it. That is another element. There are so many different aspects to respite now, with day and night respite and also shared respite. The Government is absolutely committed to this. We have funding of €25 million in 2026 to deliver more. I hope we will build on that over the coming years.

I will again echo the conversations I am having in my constituency of Carlow-Kilkenny, which are very much that respite is the single most important issue for people. Funding is great and the increase in the number of carers is all fine but what cares really want are those respite hours and that break or light at the end of the tunnel to give them some hope after what can be very challenging weeks.

Will the Minister talk to us briefly about extra staff overall in the HSE for disability? How many were recruited this year? How many more staff are we looking at for next year? The Minister mentioned that a report will come out tomorrow on the long-term plan. Will she briefly outline that for us?

Some 23,600 staff will be provided by the end of 2026. Roughly 1,000 extra staff have been provided in 2024 and 2025, and a similar figure has been provided for in 2026. I want to acknowledge the staff that we have, who are absolutely phenomenal. There is no doubt about that. The work they do is often seamless and unseen. It is certainly unheralded but it is not unappreciated, particularly by those to whom it matters.

There are challenges oftentimes in getting staff as well. In this respect we are working very closely with the Minister for further and higher education to ensure we have appropriate levels of staff coming out and a pipeline of people. We also have other initiatives, such as recruiting from abroad and working with CORU, which comes under the competency of the Department of Health. We are looking at all different opportunities in the disability sector. We are also looking at options such as student scholarships.

I thank the Minister, the Minister of State and the officials for meeting us. I congratulate the Minister of State, Deputy Higgins. I have a couple of questions, given that we are more commenting and querying and we cannot alter the outcome of what is before us for the Estimates process. The increase is undeniable and this is highly commendable, as is the focus of the Government and the dedicated section in the Department of the Taoiseach. A few issues ring alarm bells for me. Coming from the private sector, where we worked quite tightly with quarterly budgets, figures and retrospective cost benefit, this time period is quite tight. We are discussing the outturn for 2024 and then the Supplementary Estimate for 2025. How advanced is the ambition to move to multi-annual investment, planning and funding? What plans are there on digitisation and what changes in accounting practices and forward planning are taking place on the fiscal side?

From our work at the committee and meeting various people coming before us on the UNCRPD and our modules that relate to that, a recurring response from people is a preference for personalised budgets. When will the review of the personalised budget pilot be completed? What is the timeline for expanding the access? The person who was over this section has moved on to dealing with respite. I ask the Minister to allay my concerns that personalised budgets might not be as high a priority as they should be according to the feedback we get from people.

Has any work being done on the costs and potential savings of personal assistants vis-à-vis day services? Following on from this, day service funding is to increase. What assessments and reviews of the current content and quality of services have been carried out? I want to raise a flag in this regard, which Deputy Quaide has also raised. An investment company has created a company for the provision of services to people with disabilities across psychology, occupational therapy and speech and language therapy. This is about the shared concern regarding the move to increased privatisation. There is absolutely a need but I wonder about the checks and balances and how this can be monitored and altered swiftly enough. If I were to go for a nuclear suggestion, given the volume of outsourcing in place, is there a possibility of a direct link between the Department of Health and the providers, without the HSE in the middle, given there is an increase in section 38, 39 and private providers? This is thinking way outside the box. We are already at 80%. The Estimate is 80% of the total figure. In terms of getting ahead, is everything being looked at to achieve to multi-annual funding? I apologise if I am not explaining this properly.

With regard to respite care, I agree with the Minister that overnight respite is highly desired by families. We also get feedback coming to us, inside and outside the committee, on alternative respite and day respite. Is this possible? Can disability managers have discretion over, for example, the provision of alternative therapies, be they equine, music or drama, where there is capacity and there is an evidence base for the results? While we wait for recruitment in special education and healthcare, there are people who are ready to deliver services.

I will deal with some of the questions and Deputy Higgins will deal with the others. The question on personalised budgets struck a chord with me in so far as there is a commitment on it. It is under review and this is being done by the National Disability Authority. It is under way and there is a commitment on it.

We are keen to look at every opportunity for respite care. We have moved away from the notion that there is only one type of respite. People should be entitled to receive respite in the areas of interest to them. In fairness, I acknowledge those who are providing day services. I have visited so many of them that are doing the most extraordinary things. They are meeting the individual interests of people, and whether this is equine therapy, art, music or whatever it happens to be, this is as it should be. We are determined to do more and more in this.

There is a programme of work under way with the HSE on digitalisation. It is to all of our benefit that we would move ahead and drive ahead with this.

I will engage again with the Deputy on the point she made on section 38 and 39 organisations because I fully understand what she envisages there. I will go back to what I said in reply to the previous speaker. We have funding that will support section 38 and 39 organisations to do more. I do not want to take away from the valuable services being provided by others either as they are very important. The most important thing is that those who need the service gets the service, and whoever can provide that service in the shortest space of time, all the better. The capital funding and specific funding we have for residential and respite services will ensure that, more and more, we will be able to support others who are doing it in the voluntary sector.

The Deputy also asked about home support and personal assistants. Next year's budget will provide €5 million to enable the delivery of approximately 150,000 additional personal assistant and home support hours. I echo what the Minister said in particular about digitalisation. Immediately previous to this post, I was the Minister of State with responsibility for digitalisation across government, and this is something I am very keen to drive. I am very encouraged to hear there will be new IT systems and dashboards in development in the Department and that we will be looking to work with all the section 38 and section 39 organisations we support to move from paper-based systems to more automated and digitalised systems where appropriate.

Cuirim fáilte roimh an Aire agus an Aire Stáit and I congratulate Deputy Higgins. My first question is for the Minister and I will go back to the question I was not allowed to ask her yesterday.

There was a very strict Chair.

There was. We are talking about speciality disability services and the €267 million. I will go straight to the €85 million for specialist residential services. I have had the complaint many times that, at some level and in some circumstances, the State can be very reactive. A better model of planning is probably needed, particularly when we are talking about this. We are aware of the issue of those in nursing homes who are aged under 65 and should not be there. Even in cases where people have been facilitated into homes and supported homes, in an awful lot of cases the State ends up paying a lot more on the basis that it is an emergency. In some cases private operators have a greater capacity to react in this set of circumstances. Is there a plan to do this better? Is there an increase in the number of those looking for this and is there any reason for that?

I appreciate where the Deputy and we referenced it earlier. Residential placement is one of the most significant challenges we have. As I said, 60% of the entire budget is going on residential. The Deputy mentioned the under-65s and in terms of community neurorehabilitation teams we have three and we now have funding for a further three. I have seen at first hand how they can help to support the independence of people and allow them to move more seamlessly into the community. We have funding also that we will double the number of transitions for people under 65 in nursing homes.

What is the timeline for having the community neurorehabilitation teams everywhere we need? We do not have one where I am from.

The commitment is for six given the six regional areas and we will probably have to do more than that, going forward, but that is the start.

What is the timeline?

There are presently three. We have funding in 2026 and I hope we might be in a position to deliver the full three so we would have the six by the end of 2026, but we will just have to see how we go with that. I am not even sure that will meet the need. It is quite phenomenal what they do there. I have seen in my own area where people who were travelling to Cork from Kerry can now be catered to at home and everything else.

On the wider residential issue, with the funding we have for 2026, we will deliver services for 9,000 people approximately. Within that, as I said, there is €40 million for new residential placements, the €10 million for the under-65s, part of which is community neurorehabilitation. It is around €3 million for community neurorehabilitation and €10 million for the transitions. Then there are enhancements and upgrades to existing residential facilities as well.

What about the €40 million? How many people are we talking about? I get everyone is on a different level. The Minister will accept what I brought up is an issue.

Yes.

Have we a plan to improve that?

On average, it is €388,000-plus to deliver a bed. As the Deputy has identified, that will vary. Some people need 24-hour care, others need less and everything else, so that is just an average. That is where we are at the minute.

I get it. You can deal with a whole pile of issues, even in relation to families, where support is needed but they can have their own issues and worries. You are also dealing with third party operators. However, I have had it said by some who work in the sphere there probably needs to be a greater level of planning rather than just dealing with it reactively, which is generally a disaster where a family has just fallen asunder, somebody has got very sick and possibly a child or adult has been left in accident and emergency.

That is why there will be a focus that complements budget 2026 on more planned placements with the section 38 and section 39 organisations. I acknowledge they are stepping forward for that, but we will have the resources to support them for planned placements.

We do not know the number though, even roughly.

I am telling the Deputy it is on average €388,000.

I suppose it is €40 million divided.

Yes. I cannot even say that would be fully accurate because it is just an approximation.

All right. On the National Human Rights Strategy for Disabled People 2025-2030 - I also believed the action plan was being published in November but if it is being published in December we will all live with that - how exactly is it going to work? The Taoiseach said it is the unit within his Department that on some level oversees this to the Cabinet committee. How exactly does the Minister's Department fit in there and how exactly does that work, especially the oversight piece?

There is the Cabinet committee, which is probably one of the committees that is meeting most frequently in the Government. We are there at least once a month, I would say. There is the Cabinet committee but there is also the implementation group. That is chaired by the Taoiseach and on it are the various Government Departments but also nominated individuals representing people with disabilities. Underneath that again, because this is a whole-of-government strategy, each Department has accountability for various pillars within the strategy, and there are also disabled people on the subgroup they have. They have crafted the strategy in the first instance, so they are part of the implementation and, through the implementation, part of the accountability. The meeting for that is in the first or second week of December. It is 8 December or 9 December - somewhere around then. Also, each Department delivers the action plan and part of the delivery of the action plan will help disabled people, working with each individual Department, to do what they have to do.

Questions to the Taoiseach on disability were cut short today because we were over time, so it is good to get this opportunity. One of the big challenges for adults living with disability is trying to escape the poverty trap. There is a cost of disability estimated at nearly €500 a week. If their disability in terms of disposable income in a family is factored in, it can be up to 92% of their disposable income. We know, therefore, disability is associated with poverty and less opportunity to become employed. Even if you become employed, that employment is probably on the lower scale of payment. It is the two sides of the same coin, that is, the poverty and offering opportunities to people living with disability to get adequate training and education. Are we committed to that? It is hugely important. It is important as a human right but also to the person who is living with disability and their family to offer them hope. It is also important to us as a State to do the right thing. I am interested in the Minister or Minister of State's reflections on that.

I thank the Deputy very much for highlighting this. It is really important. I am aware it is something that is often discussed at this committee and that is because it is hugely significant to disabled people who go out to work and, unfortunately, then feel, in some instances, the negative impact of that on their household income. It is something that is very much on the mind of the Department of Social Protection. It is part of our Cabinet committee and also part of the monitoring committee the Minister spoke about that will be meeting in two weeks' time. We will expect to see this as an issue covered in the action plan.

It will be important we focus on the barriers to gaining education and skills, the barriers to employment and encouragement of employers. There are schemes already but they could be enhanced.

There is a very significant wage subsidy scheme, again rolled out by the Department of Social Protection. There are some fantastic examples of companies that have taken up that opportunity, but there is space for so many more of them to follow the good example. Recent increases have been announced by the Minister, Deputy Calleary, in relation to that as well. I urge as many companies as possible to look at that.

On education, third level education and further education opportunities and the personal assistance that might be required there, great progress has been made and again there is more and more in that space. I have a particular interest in that. I spoke to somebody recently who told me about attending at third level. The assistant she had at that time was a fellow student and she was just saying how positive that was because the person blended in so very well. It suited her and it was like another companion supporting her. I would like to see us moving more into that space where fellow students or whoever can be the assistants or personal support that is being provided. It is something I have raised with the Minister concerned as well. There is more to be done in that space. We can talk about all the strategies in the world and all the money in the world, but unless an individual feels their life has improved because of the money, the strategy and everything else, then we are not going anywhere. There are very positive steps being taken and more in that space.

Reference was made to the newer rehab units around the country. I know that in the west and north-west, there is a dearth of rehab units. In fact, we have none - it is a black spot. I know one was committed to at Roscommon University Hospital in 2015, and a budget was attached to it of €8 million. That disappeared from the capital plan surreptitiously around 2024. We picked up on it and brought it up as a Topical Issue on the floor of the Dáil, and it is back on the capital plan. New rehabilitation is critical infrastructure that should be accessible to people. We are talking about head injuries, acquired brain injury, stroke and spinal injury. It needs to be accessible. The idea that people from the west of Ireland have to go to Dún Laoghaire, a journey of 200 or 250 miles, seems ridiculous.

I agree 100%. Although it is not a competency for our Department as a health matter, I agree. It is transformative for the service user but also for families that they can travel to somewhere close to them.

I want to come back to the issue of private outsourcing of assessments of need. How much is the Minister planning to invest in that? How much of an increase does that represent on last year’s spend?

I have never made any secret of the fact that I personally believe the assessment of need process is broken, and that we need to do a lot better. I can say that there has been a 57% increase in completed assessments in the first nine months of this year, but the backlog is enormous. We need to do better. I will be bringing a memo to the Cabinet that will include the draft heads of a Bill. We are looking at how we can make the system better. It will retain the right for somebody to access an AON and will also retain the timeframe. It will focus on the delivery of timely and efficient access to therapy. We have found, for example, that 30% of people who go through the process are told at the end of the day that they do not have a disability. However, they have a need. I personally believe that the focus should be on the need from the beginning.

The Deputy asked specifically about private assessments. Approximately 6,000 private assessments were done last year. A similar tranche of funding is being made available this year, and approximately €20 million has been made available in budget 2026 for private assessments.

As we are looking at the AON aspect, we are also looking at some of the other drivers. We must be very clear that an AON is not needed to access health services, whether for mental health, primary care, CDNTs or whatever the case may be. People are still accessing that. We are working with the HSE on two different things. One is that there would be a single point of access, so people are not on a multiplicity of lists. That would be a big help to families. Second, the HSE is working on an autism protocol, so there will be a single and more expedient access point for autism diagnosis. Again, it is interesting to see that 45% of all of the completed assessments in the first nine months of the year had an autism diagnosis. We are looking at things in the round.

The third thing we are looking at is working with the Department of education regarding the AON being required for special classes or special schools. We are working very closely together. Going forward, it should be education-led as opposed to AON-led.

I am conscious of the time. I thank the Minister for that response. I agree with some of what the Minister said. There is a lot of concern about the potential change to the right to an assessment of need, because it is the one right that is legally enshrined at the moment. I also believe that many families are getting stuck in that avenue unnecessarily, but the reason they are getting stuck is that the therapies are not resourced enough. A lot of families are seeking out an assessment of need when they might benefit more from timely therapeutic assessment in the primary care services, and timely intervention after that. As we know, an assessment of need is only useful insofar as it is an access point to interventions.

On that theme, has the Minister engaged with the Minister for Health, Deputy Carroll MacNeill, on the crisis in primary care services for young people, which impinges on both Departments? I know it comes under the Department of Health for funding, but there is a strong interplay between health and disability. It is for this reason that we are going to have a joint session of the two committees on this crisis. I say that because a significant part of the crisis in primary care occurred historically, and some more recently, due to a large number of children being transferred from CDNTs to primary care waiting lists in the rollout of Progressing Disability Services. That was not followed by the necessary recruitment. There has been a very strong political focus on CDNTs. It is true to say that recruitment restrictions have not been applied in the same way to CDNTs, which is welcome, but the neglect of primary care services actually deepened in that context. As much as it is not officially in the Minister's area, it is very important that both Departments are working together. There are many children on primary care waiting lists who have developmental mental health issues, and they may even meet the criteria for disability. All of this is interconnected.

On disability, there is cross-government alignment around working together and focusing on the best possible outcomes for people with disabilities. With regard to the CDNTs, we have had a 26% increase in staffing in the CDNTs, notwithstanding that it is not perfect and there are vacancies. Budget 2026 has made provision for an additional 150 staff to go into the CDNTs. We have been challenged in terms of ensuring that we have a pipeline of young people who are trained and skilled. We have seen an increase in placements and student scholarships, and there is also an interesting development that is working favourably. There has been a 30% increase in clinical placements in CDNT teams as an encouragement to people, who can see how it works and then consider working in CDNTs going forward.

I asked specifically about the possible engagement of the two Ministers. Has the Minister engaged with the Minister, Deputy Carroll MacNeill, on this?

Indeed. I have engaged with all Ministers, including Deputy Carroll MacNeill. I engage with all Ministers, in particular in relation to our strategy and staffing issues. All Ministers are part and parcel of the disability strategy.

I have a couple of follow-up questions on the 1,100 extra day service places for next year and onwards. Is there any way of ensuring that the assessments take place in the penultimate year of school? Throughout the country, and definitely in County Meath, there is a gap between there being no assessment or the assessment coming very late in the day, which means the placement in day service may not be the best match for the young person. If it was in the penultimate year, better forward planning could be done. Is there any departmental assurance that this could happen?

Second, I want to raise a flag about something that has arisen in my county. It concerns emergency planning for bereavement or force majeure. I know there are no mandatory plans, but is this something that might be looked at? It seems to be quite ad hoc, from talking to colleagues around the country. It goes from there being no planning to somebody having the mobile number of, perhaps, a disability services manager or a respite co-ordinator. That ad hoc piece is very unsettling if a force majeure event arises.

To go back to the figures, given the €260 million overrun, and notwithstanding what the Minister said about HSE digitisation, is there any departmental digitisation being done, or any linking in with early years public health nurses, in trying to forecast the services that will be required and planning ahead? I appreciate that all takes a huge amount of effort and time.

In relation to the significant amount of additional funding required for the Child and Family Agency, I note that there are savings on the pay side. I think it is €14 million. I wonder, though, if there is an issue there in terms of counterproductivity. On the one hand, there is a saving, but human resources are the very resources required for case reviews, handling case overloads, responding to emergency issues, etc. Are there any plans or interventions envisaged by the Minister's Department to try to improve on that?

I will just take the Tusla one. It actually came up in the select committee on children yesterday as well, but it is no bother. I will just reference it. In terms of the funding for Tusla, an additional €170 million is being made available to the agency in budget 2026. This is in addition to the €145 million in budget 2025. Tusla itself would concede it is significantly resourced, notwithstanding it has a whole gamut of responsibilities, specifically in terms of staffing. Tusla has been very creative in terms of staffing. The agency, for example, was particularly challenged around special care, so a new grade has been introduced. Significant recruitment is also taking place. This includes advertising campaigns at home, but where we cannot match the requirement, there are also advertising campaigns abroad, too. This has resulted in nine individuals coming on board from the special care point of view. Nine are in place, six are due to be in place in the next couple of weeks and a further four are in the process of registering. Where there are challenges, therefore, huge efforts are being made. Equally, there are the kinds of initiative being supported. I mentioned sponsorship earlier. There are also initiatives around an earn-and-learn approach. The area of social work is another where there is a particular demand, so we now have the earn-and-learn apprenticeship model. There are also the tertiary opportunities for social work. A huge effort, therefore, is being made in terms of staffing, as the Deputy referred to.

In terms of day services and the earlier planning issue, a transitions programme is up and running with the Department of education to support just this area. We have moved earlier in terms of supporting people moving forward and on, but we are always seeking to move that timeframe earlier and earlier. I think the earlier it is, the maximum opportunity it gives people. This concerns not just service users or the individuals, but families. Families need to be very confident. They are used to having the school setting, as is the individual. There is a lot of confidence around that, but it is a big change when moving to something else.

The Minister of State, Deputy Higgins, also wants to talk about digitalisation.

I am just conscious of time. We are working very hard to enhance data systems and governance, not just across our Department. We are also co-ordinating with other Departments. We know doing this is going to help from the perspective of budgetary oversight, capital planning, governance arrangements, grant funding, oversight, workforce monitoring and even service delivery itself when it comes to monitoring it. That body of work is happening.

I thank the Minister and Minister of State.

There will be updates on that as well.

We meet again. It has been two days in a row.

I know.

These are late nights, but it is important work. I congratulate the Minister of State on her new appointment. I am sure she will work just as hard as she did in her last Department.

I heard the discussion on assessment of need, AON, before I came in and upcoming changes were being spoken about. Just this week, I was part of the problem when I referred somebody for an assessment of need because they had engaged with their primary care service and been told to wait and see until the child reached the age of three before any assessment would be done. Enrolment in a playschool took place this week. The child is not at early childhood care and education, ECCE, level yet, so it is not possible to get an access and inclusion, AIM, support worker. They do not think that playschool is an appropriate place. I told the parent that if there was a diagnosis of autism, which the child is showing characteristics of, I know it would be possible to get home tuition from two and a half to three years of age. If there was not an appropriate place then, it would be possible to get 20 hours from three to four years. I am part of the problem this week in increasing the waiting list, but I did not see any other way forward for those people.

It is interesting because we briefly had a discussion around autism in the context of the AON. I said the HSE was imminently introducing a new autism protocol to ensure faster access to autism diagnoses. This is because we have found that, of the last nine months of completed assessments, 45% of them were actually autism diagnoses. People have been going through the very long protracted assessment process when in fact, as the Deputy pointed out, it might initially be indicated it is autism. The new autism protocol will help to support this area and provide a better avenue for people who want to pursue that approach.

Broadly in terms of the AON, we made reference to the fact that 30% of people who went through the process were told they did not have a disability but did have a need. Faster access to therapies is what is required. Equally, we will be bringing a memo to the Cabinet, including the draft heads of a Bill, in terms of a reworking of the AON process as it is. It will retain the right to access an AON and the six months, but it will have an emphasis on faster and more efficient access to therapies.

I agree with the Minister. I think once we increase services, many of the people who do not necessarily require an autism diagnosis might not go for the AON because they will be getting their services. If people do need an autism diagnosis to get into an autism class, a special school or tuition, that is probably their only route at the moment.

Yes.

In the short time left, in relation to the children's disability network teams, CDNTs, it is great to see there was increased funding for them this year, but I know we are struggling with recruitment. Is there anything in the budget for outside-the-box recruitment ideas? We have many therapists in Australia, Dubai and Abu Dhabi. I refer to getting them home. We obviously do not have housing. In the west of Ireland, a vacant CDNT speech and language therapy, SLT, post has essentially been closed and moved into being a managerial post. It will, hopefully, bring boots on the ground by way of a new manager, but for that CDNT specifically, it was a vacant post for a number of years. It is now a closed post. Although we welcome having a new manager and new boots on the ground, we are still short that SLT post and it will not now be filled. What are we doing in terms of recruitment and have we money specifically in the budget to entice people home? Are we looking at housing options or what is our plan?

I thank the Deputy for that question. A huge amount of progress has been made on this issue this year. In the 18 months prior to April, there was a 27% increase in staffing in our CDNTs. That is not just new vacancies being filled but also retention, which is an issue as well. I think it is really important that we retain and develop our staff as well as attract them.

Does the Minister of State have a breakdown of the figures in terms of east versus west and urban versus rural? I know the likes of Donegal, Mayo and those more rural areas are struggling.

We can certainly see if we can get that information to the Deputy.

That would be good.

Going forward, it will very much be clear that we will be making sure that posts for the CDNTs where we have the highest recruitment vacancies are where we are targeting our recruitment campaigns the heaviest.

I thank the Minister of State.

If the Deputy has any innovative ideas in terms of getting people home who are currently working abroad, we would absolutely love to hear them and partner with the Deputy on that.

On the CDNTs, CORU is the competency office in the Department of Health, but we have engaged there in trying to expedite and make things more efficient because it is a very challenging process for some. I see the Deputies are smiling. It can be a very challenging process for those who wish to come home. Work is under way with CORU in this regard, and I acknowledge the work of the Minister for Health, Deputy Jennifer Carroll MacNeill, in relation to it. We are looking at all other avenues as well. I mentioned earlier that there were sponsored scholarships now to attract people to work in the HSE and specifically in the CDNTs. There are also clinical placements. I mentioned to Deputy Toole that this had proven quite effective. There has been an increase of 30% in the number of clinical placements. This means students will get a taste of what it is like to work in a CDNT environment while they are training.

That is a real positive and they will see it as an opportunity going forward.

Regarding the pipeline, over 460 or so additional places are being provided across a variety of disciplines in further and higher education - speech and language, OT and all the various disciplines that are requires - and there are more to come. The significant majority of those came on stream in 2025.

I think there is a vote.

The Chair is allowing flexibility. Always take that flexibility.

I will. I just want to support everything the Minister has said. It is about retaining our staff, recruiting more, growing our talent in Ireland, keeping our talent and attracting more talent in. CORU and work permits are a huge part of that.

With the members' agreement, we will have another suspension and come back when the vote is over.

Many of the issues that relate to disability do not necessarily fall within the Department. We had a conversation earlier. The Department of Social Protection plays a huge part. Many of us have put in the public domain the absolute necessity to follow through on a cost of disability payment. I would much prefer it to happen before the next budget but it definitely needs to happen. Deputy Daly brought up the low level of employment that we have in the State. It is about how the Minister will engage on this with the Minister, Deputy Calleary's, Department. The wage subsidy scheme has fewer people, both employers and employees, than it had in 2018 and 2019. There is still a need for a major overhaul. It does not have sufficient flexibility. I am also saying that the work and access scheme, whether we are talking about assistive technologies, or whatever can be done with regard to reasonable accommodations, needs a huge level of work, and we need a greater level of workability-type projects across the board. That goes without saying.

I would also follow up with what was said earlier about personalised budgets and the complaints that even when they are in play, we need to make sure there is sufficient flexibility to give people the freedom they need. A complaint has been made about personal assistance hours, that sometimes that gets morphed into home supports. They are issues that need to be dealt with. I will ask the Minister to comment.

While I am here, the Minister spoke about the AON. Obviously it has been broken. We have all talked about the issues in relation to education. When does she think that particular part would be dealt with? When will we see an autism protocol that will facilitate those who need an assessment of autism? I do not think anyone would disagree about access to therapies and efficient access to services. I would also say many people would say it is difficult to fill the positions within the CDNT at the same time that you need to fill the positions in schools.

The autism protocol is within the HSE but I understand it hopes to roll that out early in 2026.

How does that improve the scenario around getting an assessment?

Of the completed assessments of need in the last nine months-----

I get that

-----a total of 45% of them were autism. There is a view that people will choose the route of the autism protocol as distinct from the assessment of need, not in any shape or form withdrawing the right to the AON, but-----

No, but it will facilitate that. I think some people would be happy if that option was open to them. It is just the sooner, the better.

Yes. I understand it is aiming to do that in the early months of 2026. On the education aspect of the AON, we have engaged significantly with the Department of education about lifting the requirement around special classes and special schools for an AON. I acknowledge that it is prepared to accept that and it is currently working on the application for either the special class or special school being education-led as distinct from AON-led.

When does the Minister think that will be sorted?

I would like to see that next year, personally, but it is not within my competency. Even if it was on a phased basis, it is a matter for the Department of education. At the minute, it is looking at 2027, but I think if we could row that back a bit, it would be helpful and positive. I want to be clear that home supports and personal assistance are two distinct things and provide different supports. One is for maximum support within the home. The other is to provide independence to live a life within the wider community. I would not for one minute want or allow-----

It is a complaint from users.

I understand the point the Deputy is making. I have had a number of meetings with the Minister, Deputy Calleary, about the personalised budget and the wage subsidy. Improvements have been made in funding for the wage subsidy. The Minister, Deputy Calleary, has been proactive in this space and would be open, on an ongoing basis, to looking at whatever measures are necessary. Changes have been made already to the wage subsidy. That will be looked at on an ongoing basis. It is phenomenal what the companies which have taken up that opportunity have achieved.

We need more of them to do it though

We need more of them to step forward. It is about making them aware that it exists, the opportunities it provides, and the advantages to them and what it brings to their company and set-up when they support somebody with a disability.

Those that employ a greater number would also complain that they did not get the increase. When talking about bigger numbers, in some cases, it is only 55 cent extra per person, whereas there is an added cost for employing multiple disabled people. It is a particular piece that needs to be worked out. I wanted to raise it.

How does one fill the CDNT at the same time that one is trying to get in-school therapy?

I have had that discussion with the Department of education. There is an understanding that our CDNTs must be protected and that they are not drawn from. We hope there is an opportunity to monitor both. It is not to deplete one and increase another. That would be the strong view of the-----

One could take away the pressure on the other.

True, but there will always be a place for the CDNTs.

Definitely.

I am a big supporter of the therapies going into the schools. I believe it is a real positive. The child is there in the first instance, so there is automatic access. We will see how that works in the next short while.

The Minister talked about therapies going into schools. I am not sure if she is aware that we did a number of modules on access to education in schools for people with disabilities. Corpus Christi Primary School from Moyross with its project, the sky is the limit, came in. I suggest, if the Minister has not seen that, that she looks at it. It will hopefully be a key part of the report we will do on that issue. The Minister spoke about assessments of need. Many members have spoken about that. We all agree that there are massive problems. The Minister used the word "broken" herself, as did Deputies. She is talking about a new version of that in the new year, which will hopefully disentangle people with autism, so they can go to a different service. I think the Minister clarified it but she might do so again. On the concerns people would have about that, would people still have the right to the assessment of need and would the timeframe be the same?

Yes.

Will there be a sanction, or what will we do if we miss the timeframe?

We are saying that, as it exists, it is not working. It is not delivering what it should deliver. We are taking the opportunity through legislation. The memo to Cabinet and the heads of Bill will come before the end of this term and it is only a matter of weeks, or as quickly as we can within that timeframe. It will retain the right to the AON and the timeframe, and it will focus on faster, more equitable access to therapies in the first instance. That is the first step. The autism protocol, which is not within our gift, will help, if it is appropriate to people and is what they want to do, but they will still have the AON opportunity too.

Single point of access for people will be a massive help. Instead of adding people to 101 different waiting lists, there will be one point of access. It will be a huge help to us when the Department of Education and Youth is in a position to begin no longer requiring the AON for the special class or the special school. It is not one single measure that is going to improve the situation with the AON. It will have to be a number of different initiatives working on the same path to improve access to the assessment.

Can the Minister briefly comment on the number of private assessments being done at the moment? I welcome any assessments we can get done. What is the average cost of a private assessment?

I do not want to mislead the committee. Under the new tender arrangement, it is €2,900 or something like that. It is costly but we cannot have young people on the list forever and a day, and this is making some inroads. There were 6,000 assessments completed last year.

I want to return to my concerns about the private outsourcing of assessments of need, not only because of the vast amount it diverts from public services, but the perverse incentives created for clinicians to leave the very services we need to resource. The Minister mentioned a figure of €20 million for privately outsourced assessments of need. Is that for one year?

That is what is in the budget for 2026.

I did a bit of digging into figures recently, and in a nine-month period between 2024 and this year, the Department spent €12.5 million on outsourced AONs. That, incredibly, equates to the starting salary of an occupational therapist for 290 years. The starting salary is around €43,500. The real worry I have is that the Government is actually hollowing out public services at the same time as it is bundling huge amounts into a sort of dead end, because even if someone gets an assessment of need, it does not necessarily lead anywhere if there are no interventions in place. I would like the Minister to take that on board.

I want to come back to the private for-profit residential services that some of my colleagues mentioned and Deputy Ó Murchú's comments on the need for a long-term plan to know where we are going with this. Through a parliamentary question reply, I identified a near doubling of proportion of spend on private for-profit residential services for intellectual disability. I welcome very much the budget increase for disability services, but we really need to look carefully at where that is being spent. What tends to be the nature of a contract for a residential placement with, for instance, Nua Healthcare or Talbot Group or Haven Living? Does the Department tend to sign up year by year or is it a long-term contract? Can the Minister give a comparison on cost per placement between a private for-profit residential placement versus a section 38 or section 39 residential placement? What is the general cost difference?

I hear what the Deputy is saying about the impact the AON can have, but I think we all agree that it is not working as it stands. We have to do something, so we are providing opportunities for those who need the assessment. However, we are moving forward in a different timeframe in 2026 where we are talking about the new legislation and where the focus will be on ensuring people continue to access AON if they wish within the timeframe. Equally, we are looking at other measures, like the HSE introducing the autism protocol, the Department of education removing the requirement of AON for special classes and special schools and the single point of access. All of those measures to reduce-----

Those measures do not paper over the cracks of chronic under-resourcing. We also need to resource services.

That is what the entire budget is about. There is €618 million additional funding going into disability. That is the single biggest uplift we have ever seen.

There is too much going into private outsourcing.

In the short term, but in the longer term, particularly around the AON, we are moving in an entirely different direction.

Is that being done on residential as well?

Certainly, we referenced that earlier.

I raise the slight underspend on the access and inclusion model, AIM, which we discussed yesterday at the children and equality committee. I welcome that the scheme has been extended to the full day this year. I also welcome the 10% increase in the capitation for level 7. However, a child was referenced earlier who is two and a half years old and will not start the early childhood care and education, ECCE, programme until September. The child is not currently getting a lot of personal resource hours or access to speech and language therapy or occupational therapy but if she had AIM support, she would be able to attend playschool, but she cannot get AIM until September when she is in ECCE. Are there any plans to change that?

We keep everything in this space under review. We give the maximum opportunity we can to children. There was a positive step forward, which the Deputy referenced, in giving the additional three hours with AIM support. That is a really positive step forward. We must also be mindful of working closely with the Department of education in terms of early intervention classes and what can be achieved there.

A child cannot get into an early intervention class unless they have a diagnosis.

I am talking about the whole suite of measures; it is not any one single measure. I have a particular interest in AIM that because it opens opportunities. It did not exist previously for people who did not have AIM support. There are a variety of ways of accessing that support, whether it is the extra pair of hands in the classroom or a reduced classroom size or whatever the case may be.

It would cut down on people going for an assessment of need if they could access that AIM support before ECCE. That means they could get out of the house five days a week. If they are too late and miss the September window, it could then be October, November or December. That means from September to December that child cannot go to playschool because she will not be able to access AIM support, but she is still waiting for an assessment. It might be a good way to funnel resources and to allow people to get therapy within schools.

I am not ruling anything out at all. I am very happy to look at every possibility and potential. It is not there as part of our plan for 2026, but all things being equal we will be here for a few years more and we will see how we go.

I have a suggestion that may have already been considered for graduates. It is that there could be a two year post-qualification retention and then they would be prioritised on return from abroad, registration dependent.

The feedback we get in our area on assessments across all disciplines is that approximately 30% of time is spent writing reports. I refer to linking in with the colleges of further education and training. For example Dunboyne near me has gateway courses linked to third level and there may be opportunities to run pilots. It could be budget-neutral because it deals with students who are in the system.

I think the point around duplication of recruitment with the NCSE has been covered. If not, I would welcome the Minister's feedback.

According to people we have met at the committee across the different modules, transportation is a barrier, particularly in rural areas, for accessing day services and employment. With regard to interactions with the Department of Transport and the NTA, what will be coming in the transport space?

Regarding the two-year retention of students, I assume the Deputy means they will go through the sponsorship programme and be retained. That is the idea behind it and that is happening in a lot of other instances. In terms of the writing of reports, did I understand the Deputy meant we would have some kind of assistant?

Yes.

Yes, I absolutely agree with that.

There is great scope for something like that. It is not only from an administrative point of view. There are opportunities for therapy assistants -----

I am sorry to interrupt the Minister but another vote has been called. If she would like to wrap up quickly, we will finish the session if everyone is happy with that.

That is the fastest question that anyone ever asked.

I did not get any answer on the questions on the nature of contracts for residential -----

We are out of time, in fairness. The Deputy had his time.

I asked a question. Do we not have until 9 p.m.?

There is a vote.

We can suspend and come back from the vote.

I did not realise there was a vote.

We will go on for one minute then.

The Ministers are talking aboutan increase of €618 million.. Can we get a breakdown of that? Is any of that just to maintain existing levels of expenditure or service?

The Minister and the Minister of State are both aware of Kevin O'Brien, Variety and the disability trikes. I am talking about maintaining the commitment to the recycle mobility programme and beyond that ensuring that the likes of the Collinstown project are ramped up, no pun intended, and carried out throughout the State. It is about ensuring the funding is there.

I thank the Deputy. I was at the brand new cycling inclusion centre of excellence in Collinstown.

I saw the video.

I am delighted. It was really good and I want to pay tribute to all the fantastic work Variety is doing. Yes, some of the €618 million funding is to increase funding for services that exist. The Deputy will note we are here at the Estimates meeting because we have overruns on an annual basis so we want to go in with a better slate, as it were. On top of that, there is also a significant extra funding for new initiatives as well and the recruitment of up to 150 posts.

That is the first time in my life I will apologise to Deputy Ó Murchú. He only got one minute there so apologies for that. Can the Department come back to Deputy Quaide for the questions he raised?

We would normally ask the Minister if she wanted to make concluding comments. If she wishes to, she can do it very briefly.

I thank the Chair and the committee. I appreciate the opportunity to be here and to be joined here by my shiny, brand new Minister of State. I thank the officials as well and to the committee secretariat. It has been a very protacted evening in terms of bells and everything else.

I never congratulated Deputy Higgins so I want to congratulate her.

I thank the Chair. I am looking forward to working with everyone.

I thank the Minister, the Minister of State and all their officials for attending =.