HSE paid five private, for-profit firms over €300m for disability services in 2025
The HSE paid at least €306 million to five private, for-profit companies for the provision of disability services in 2025.
That figure forms part of a wider €526 million spent on roughly 220 companies providing such private care for people living with disabilities in the same year, the Irish Examiner revealed.
The new figures, released to TD Liam Quaide, show the HSE spent 58 per cent of its expenditure on commercial companies, or just 2 per cent of the agencies in question.
The disabilities budget has ballooned in recent years, jumping from €2.8 billion to €3.8 billion between 2024 and 2026, but heightened spending on for-profit has led to criticism that it is unclear how much of the spending is being utilised to provide much-needed residential accommodation for highly vulnerable users.
The HSE estimated its funding for disability residential services at €1.7 billion in 2024.
However, it has repeatedly said it is not possible to extract the level of spending on for-profits for residential services alone.
In 2024, the HSE spent €295 million on the top five for-profits in the disabilities sector, with those five companies being Nua Healthcare Services, Talbot Group, Resilience Healthcare, GAIRO, and Orchard Community Care.
With a spend of €128 million, Nua Healthcare accounted for just under 45 per cent of that spend alone.
The spend on the same five companies in 2020 was just €129 million, representing a 129 per cent funding increase in just four years.
Quaide said: "Approximately €526m in 2025 to around 220 for-profit disability providers is a very significant sum.
“This still falls well short of transparency. It does not show how much relates specifically to residential services, how much relates to children as against adults, or what the exact expenditure was."
Of the figure of €526 million, a HSE spokesperson said that the providers in question “deliver a range of disability services, including residential, day and respite services, as well as home support, personal assistant services, and therapeutic assessment and intervention”.
Roughly 16 per cent of residential services are now provided by for-profits, a figure which has doubled in just the past five years.
“To meet the specific needs of each individual, the HSE works in partnership with both not-for-profit and for-profit organisations to ensure the best level of service possible is provided to people with a disability and their families, within the available resources,” a spokesperson said.
The levels of for-profits operating in the Irish health market have caused concern in recent times, notably concerning nursing home services, amid suggestions that relying on large-scale organisations focused on profit-making and cost-cutting could lead to a substandard level of care.
