State ‘facing shortfall of 500 beds’ in facilities for most vulnerable homeless people

The State is facing an estimated shortfall of up to 500 beds in facilities for some of the most vulnerable people in the homeless population, an internal Government document says.

It comes against the backdrop of increasing homeless numbers, with officials also told of increased demand for health and social care support due to the complex needs of people entering emergency accommodation.

A paper, drawn up for senior officials this month, said there were 1,130 beds available in long-term supported accommodation.

According to the document, most people in these services “have a history of homelessness, have enduring social or healthcare needs and would not be able to live independently”. Long-term settings provided a “secure home” for these people.

Officials were told “significant demand” existed for more long- and short-term beds including healthcare support, with the HSE estimating that based on available data “the demand [for long-term capacity] ... could be in the region of an additional 500 beds”.

The paper was written as part of Government efforts to develop a new framework for the provision and funding of health services for people who are homeless.

It said that where there was unmet demand for long-term accommodation it could result in placements in other accommodation breaking down, increased use of acute hospitals by vulnerable homeless people and prolonged stays in emergency accommodation.

Hospital discharges could also be affected where there was no appropriate place for someone to move to.

The paper is expected to be discussed by senior ministers and Coalition leaders this week.

It was drawn up based on research conducted by a working group looking at funding and support for homeless people. The group included officials from the HSE, the Department of Health and the Department of Housing.

The group examined the health services required for homeless services and looked at gaps in provision.

It found that some in homeless services may have multiple and complex support needs and may face challenges in accessing mainstream services – and therefore could benefit from additional support to engage with care.

The paper said demand for health and social care supports within homeless services has grown, “reflecting both the growth in the number of people accessing emergency accommodation and reported increases in the complexity of need”.

It found a higher prevalence of health needs among people experiencing homelessness, especially those who become long-term or entrenched, while it argued that all those entering homelessness should undergo an assessment of needs including health and social care requirements.

Focus Ireland director of advocacy Mike Allen welcomed work to recognise the support needs of people who were homeless, but said it was “disappointing to see that additional homeless beds seems to be the only concrete response”.

“The proposal for 500 additional beds recognises the pressure the homeless system is under, but fails to recognise that homes are the answer,” he said.

The paper found access to services varied depending on region, but said access to healthcare supports should be based on need not geographic location.

It said further clarity was required across HSE regions and homeless regions regarding the process and funding streams for healthcare provision.

A Department of Health spokesman said the framework was being developed in line with the Government’s housing plan.

He said the Department provided €60 million in ring-fenced funding for tailored healthcare services to people experiencing homelessness in addition to mainstream healthcare.

Budget 2027 provided €2 million extra for these services, including €1 million for individuals with complex needs and the same amount to expand integrated care and case management, including certain services in private emergency accommodation.