Press Release: Value for Money Report on the provision of disability services by nonprofit organisations

The Comptroller and Auditor General, Mr John Purcell, has today (15 March) published a report on a value for money examination on the provision of disability services by nonprofit organisations.

Background to the Examination

The State provided ?877m to nonprofit organisations to provide health services to persons with disabilities in 2004.The examination focused on the arrangements between the State and the nonprofit sector for the provision of these services and the issues that will have to be addressed in future delivery of the services.

Main Findings

  • It is likely that for the foreseeable future nonprofit organisations will continue to provide most disability services.However, the capacity of nonprofit organisations to initiate new services and expand and develop existing ones is constrained and it may be opportune to assess the long-term sustainability of the procurement approach and to examine the consistency between the organisational missions and State service provision intentions.
  • The results of the examination would suggest that the HSE will need to address its relationship with providers in the light of the substantial change agenda for delivery of disability services.This will include the specification of individual needs in service statements, the establishment of comprehensive client databases, the implementation and monitoring of standards, and will coincide with significant annual increases in funding for the provision of the services.
  • Existing databases on needs are incomplete and not always reliable but it is clear that there are significant unmet needs in both the intellectual and the physical and sensory disabilities areas. An integrated national database would facilitate better planning, management and research.
  • There is a need to move away from the funding of nonprofit organisations on an incremental basis towards an approach which more clearly links funding to levels of identified need and to areas of greatest need.
  • The examination found that greater transparency in financial reporting is required which would provide assurance regarding the application of funds by the State and the management of the related services.
  • Two cases noted in the course of the examination highlighted the importance of proper monitoring of service provision and dependency levels of disabled persons.In one organisation a custodial culture had developed largely due to resource constraints and, in another, the failure to align funding with service requirements resulted in excessive costs.
  • Any restructuring of the service should be based on clearly articulated agreements setting out the respective roles of the health service, as funder, and the service providers.The capacity of nonprofit organisations to meet the additional requirements relating to the implementation of the standardisation of services, good governance and greater accountability will need to be addressed.

Notes for Editors

The Comptroller and Auditor General is an independent constitutional officer with responsibility for the audit of public funds.He reports to Dáil ?reann.

The full text of the report is available on the website of the Office of the Comptroller and Auditor General (go to

For further information about the report, please contact:

Richard Rapple at (01) 6031000 or (01) 6031038 or at