Social Democrats TD Liam Quaide is seeking full transparency from the HSE on the cost of outsourcing Assessments of Need and has called for proper State investment in primary care services.
Deputy Quaide, who is the party’s spokesperson on disability, said:
“I have submitted parliamentary questions to each of the six health regions, seeking a breakdown of costs relating to outsourced Assessments of Need since 2022. However, the HSE is refusing to release this information, characterising it as ‘commercially sensitive’.
“I asked the HSE for the total cost of Assessments of Need per provider, and the most expensive assessment per provider. So far, I have received responses from three health regions but, frustratingly, none of the requested figures have been provided.
“Assessments of Need are the only right under disability law that a child with additional needs has, yet the government is failing thousands of families in this area.
“The HSE has estimated that by the end of this year, 25,000 children could be overdue an assessment. A right to an assessment is only useful insofar that it leads to intervention that will help the child to reach their potential. Children – and indeed adults – with additional needs should also have a legal right to intervention, but instead there are increasing indications from government that the right to an Assessment of Need will be watered down under new legislation.
“In an attempt to meet their legal obligations, the government is pouring increased funding into outsourced Assessments of Need. At the same time, they are applying recruitment restrictions through the Pay and Numbers Strategy to the very services that could provide a more streamlined pathway of assessment and intervention for many of these children.
“In addition, significant numbers of children have been transferred from Children’s Disability Network Team (CDNT) waiting lists onto primary care waiting lists, yet recruitment for primary care services hasn’t followed.
“Outsourcing Assessments of Need on a mass scale increases the fragmentation of services for young people.
“The absurdity of this approach is further underscored by the millions of euros the HSE spends every year defending legal cases taken by families who are trying to access an Assessment of Need through the courts for their child.
“This outsourcing is also creating a perverse incentive for clinicians to leave the public service and take on private clinical work – thereby making the problem of under-resourcing within the HSE worse. Between June 2024 and March 2025 alone, the HSE spent €12.5m outsourcing Assessments of Need. That equates to approximately 290 years’ worth of the starting salary of a staff grade occupational therapist.
“The HSE must be transparent about the costs to the taxpayer of increased outsourcing of Assessments of Need. It should, as a matter of urgency, devise a workforce plan for primary care services that is based on a clear number of clinicians per population size in each health region, with increased staff ratios in areas of social deprivation.
“This plan needs to be followed immediately by a comprehensive recruitment drive. This would provide much greater continuity of care for young people, reduce dependency on expensive outsourcing of assessments, and improve retention of staff in services that are struggling with out-of-control waiting lists.”
September 4, 2025