Supreme Court Clarifies Status of IFSPs as “Health Services” and Mandates Greater Specificity in Disability Service Statements

Introduction

Y & anor v. Health Service Executive ([2025] IESC 26) is the first Supreme Court judgment to rule squarely on two inter-locking questions under Part 2 of the Disability Act 2005:

Whether an Individual Family Service Plan (“IFSP”) can itself constitute a “health service” capable of being specified in a statutory service statement; and
What level of detail and nexus to the original assessment of need a service statement must contain in order to satisfy section 11(2) of the Act and Regulation 18 of the 2007 Regulations.

The Court (O’Malley J., for a unanimous panel) dismissed the HSE’s appeal, holding that although an IFSP is a permissible health service, the particular service statement for the child “ZR” was still unlawful because it failed to:

Explain the pivotal role of the IFSP process;
Demonstrate how the plan related to the needs identified by the assessment officer; and
Record outstanding unmet services as section 13 data.

Summary of the Judgment

1. The statutory distinction between a resource-blind assessment report (section 8) and a resource-aware service statement (section 11) remains intact; not every therapy named in the assessment must appear in the service statement.
2. An IFSP—properly understood as the family-centred gateway to interventions provided by the Children’s Disability Network Teams—falls within the definition of a “health service” in section 7.
3. However, a lawful service statement must still:

Describe what the IFSP will involve;
Show how its goals connect to one or more of the assessed needs;
Identify measurable actions and timelines; and
Catalogue any unmet assessed needs for national planning under section 13.

4. Because the HSE’s document did none of these things, the statutory obligations were breached; the complaint is to be reheard by the Appeals Officer in light of the Court’s guidance.

Detailed Analysis

1. Precedents Cited and their Influence

C.T.M. v. Assessment Officer [2022] IEHC 131 – Phelan J. invalidated a “preliminary team assessment” that deferred a full diagnosis, holding that statutory rights cannot be sidestepped by inserting extra procedural layers. O’Malley J. distinguished C.T.M. but adopted its underlying principle that new processes cannot dilute Part 2 protections.
A.B. v. HSE [2023] IECA 275 – Confirmed the reasoning in C.T.M. and emphasised timeliness of assessments. Used here to illustrate judicial intolerance of administrative work-arounds.
J.N. v. Harraghy [2023] IESC 9 & E.L.G. v. HSE [2022] IESC 14 – Two Supreme Court decisions clarifying the “resource-blind” nature of assessments and the “resource-aware” nature of service statements. O’Malley J. relies on these cases to reject the respondents’ argument that every assessed service must appear in the service statement.

2. The Court’s Legal Reasoning

(a) Statutory Interpretation – Two-Stage Architecture
The Court reaffirmed the bifurcated architecture of the Act:

An assessment report that records all needs, ignoring cost (s.8).
A service statement that specifies what will actually be delivered, when and where (s.11).

Nothing in the text compels the liaison officer to include all therapies recommended—hence the answer to the first certified question was “No”.

(b) Are IFSPs “Health Services”?
Section 7 defines a health service as “a service (including a personal social service) provided by or on behalf of the HSE.” On evidence of HSE practice and national guidance, the IFSP is:

A structured, ongoing partnership with the family;
The launch pad for interdisciplinary inputs; and
Delivered by professionals within, or on behalf of, the CDNTs.

Therefore, it falls squarely within the statutory definition.

(c) Adequacy of the Service Statement
Even though the IFSP was a legitimate service, the statement breached section 11 because it failed to:

Describe the IFSP content, goals, or timeframe for each action;
Show how those actions met the speech & language, OT, and psychology needs already assessed; and
Log outstanding unmet needs for section 13 reporting.

The Court highlighted that poor communication with parents was itself symptomatic of non-compliance.

3. Expected Impact on Future Cases

Service statements may legitimately specify an IFSP as the first deliverable, but must now include granular detail linking the IFSP to each assessed need.
HSE (and equivalent public bodies) must overhaul templates and training for liaison officers to satisfy the “greater specificity” standard.
Parents and advocates gain a clearer pathway to challenge vague statements: absence of linkage, measurable goals or section 13 recording will ground a complaint.
Court emphasises ongoing tension between evolving family-centred practice and the individual-rights structure of the 2005 Act—likely to prompt legislative review.
Enhanced transparency will generate more reliable national data on unmet need, feeding future budget allocations.

Complex Concepts Simplified

Assessment of Need (AoN): A multidisciplinary evaluation (speech therapy, OT, psychology, etc.) that lists every service that would help the person—money no object.
Service Statement: A practical schedule prepared by a liaison officer telling the family what the HSE will actually provide, where and when.
Individual Family Service Plan (IFSP): A rolling, family-centred action plan created with the family, setting short-term goals (e.g., toilet training, communication), assigning responsibilities to both professionals and parents, and acting as the hub for all interventions.
Resource-Blind vs. Resource-Aware: The assessment ignores cost; the service statement must face financial reality but still obey statutory duties.
Section 13 Metrics: The HSE’s duty to log which assessed needs remain unmet so the Minister can plan national service expansion.

Conclusion

Y & anor v. HSE inaugurates a nuanced precedent. The Court has legitimated the modern, family-centred IFSP framework as a “health service” under the Disability Act 2005 but simultaneously reminded the HSE that statutory obligations cannot be diluted by managerial convenience. Future service statements must:

Explain the IFSP in plain language;
Demonstrate its connection to each assessed need;
Contain measurable goals and timelines; and
Account for any unmet services in section 13 returns.

By marrying contemporary therapeutic practice with the rights-based framework of the Act, the Supreme Court has provided a roadmap that, if followed, will improve transparency, enforceability, and ultimately service delivery for children and adults with disabilities in Ireland.