About this Sector

Overview

The Irish health service is the biggest employer in the country and provides public health and social care services to everyone living in Ireland. Our services are delivered to young and old, in hospitals, health facilities and communities across the country.

These range from public health nurses treating older people in the community to caring for children with challenging behaviour, from educating people on how to live healthier lives to performing highly-complex brain surgery, from planning of major emergencies to controlling the spread of infectious diseases.

Change and innovation for better healthcare delivery

Our population is growing, and increased need for health and social care due to age and growth in chronic disease is making our current system unsustainable. We are innovating our models of care to address this, and continue to shift our response from hospital to community and home, and to promote health and wellbeing.

In 2023, we made significant progress on change and reform in the health service. We are changing our organisation structurally, aiming to improve experience and outcomes for the people we serve.

Restructuring the HSE into six operational Health Regions is a key enabler for the wider introduction of universal healthcare and Sláintecare to deliver services that are:

Integrated, locally planned and delivered
Easier to access and navigate for patients and their families
Available closer to patients’ home when they need them – right care, right place, right time.

In meeting the challenges of a significant reform agenda, eHealth will be a crucial enabler in delivering better, smarter healthcare, providing innovations and solutions that can improve access, efficiency, and quality of care.

Safer, better healthcare and ensuring that the patient is at the heart of everything we do are central to our Strategy. This emphasis seeks to ensure that people’s experience of the health service is not only safe and of high quality, but also caring and compassionate.

HSE mission and values

The HSE’s vision is for a healthier Ireland, with a high-quality health service valued by all.

The HSE’s mission is to ensure that people in Ireland:

are supported by health and social care services
can get safe, compassionate and quality care when they need it
can be confident that we make the most effective use of resources to deliver the best health outcomes and value

This mission is supported every day by the HSE’s core values. These shape attitudes and behaviour towards colleagues and the people who use the services.

The HSE’s values are:

care
compassion
trust
learning

These influence everything staff in the HSE do, from dealing with patients to actions at the executive and Board level.

The HSE encourages a culture where all staff live by these values every day, as they interact and deal with colleagues and members of the public.

Size and scope of this sector

There is an incredibly diverse and broad range of employees working in the Irish health services. An employee of the HSE could be working in an acute hospital setting, a community-based setting, a residential care home, in a laboratory, a regional office or have a corporate function to name but a few.

The following are the categories of staff employed by the HSE:

Medical and Dental

Consultants - Specialty areas

Area Medical Officers

Chief Medical Officer

Senior House Officers

Registrars

Psychiatrists

Public Health Doctors

Dental Surgeon

Dental Craftsman

Dental Nurse

Nursing and Midwifery

Clinical Nurse Managers

Clinical Nurse Specialists

Clinical Nurse Managers - Specialty areas

Staff Nurses - All Disciplines

Staff Nurses - Speciality Areas

Public Health Nurses

Midwives

Health and Social Care Professionals

Physiotherapists (Basic Grade, Senior, Manager)

Radiography (Basic Grade, Senior, Manager)

Speech and Language Therapy (Basic Grade, Senior, Manager)

Occupational Therapy (Basic Grade, Senior, Manager)

Social Work (Basic Grade, Senior, Manager)

Emergency Medical Technicians

Audiologist

Dietitian

Orthoptics

Psychologist

Science/Laboratory

Analytical Chemist

Biochemist

Medical Scientist

Pathology technician

Physicists

Management/Admin/ICT

General Administration

Specialist Areas:

Finance

Human Resources

ICT

Corporate Affairs etc

General Support Staff

Attendants

Drivers

General Operatives

Nurses Aides (Care Assistant)

Home care assistants

Supplies Officers

Technical and Maintenance

Draughtsman/Technician

Electrician

Engineer/Engineering Officer

Maintenance craftsman/technician

Mechanic

Plasterer

Plumber

Technical Services Officer

Catering and Housekeeping

Catering Officers

Chefs

Cooks

Dining Room Staff

Housekeeping Staff

Porters

Laundry Staff

All our positions are advertised on www.hse.ie .

Current issues

Recruitment and promotions in the Health Services currently operates on the basis of the Pay and Staff Numbers Strategy. This means that each employer needs to operate within their own budget and all senior posts must be sanctioned by the Department of Health.

It is Government policy, in the case of Medical Consultants, to move to a consultant delivered service, and in the case of the other grades to increase their numbers in order to meet the requirements of integrated care delivery and address community and primary care needs particularly in respect of children at risk, the elderly and those with disabilities.

Anticipated changes

We want to provide a health service which becomes world class, is available to people where they need it and when they need it. It should provide people with the very best outcomes which can be achieved, as this is what everyone who uses our services expects. We have therefore set ambitious goals and priorities which will stretch us. We may not be able to achieve all of them but we will certainly make every effort to do so.

Safer, Better Healthcare and ensuring that the patient is at the heart of everything we do are central to our Strategy. This emphasis seeks to ensure that people’s experience of the health service is not only safe and of high quality, but also caring and compassionate.

The delivery of better quality care requires that the HSE puts in place the most effective clinical care pathways that are integrated across acute, community and residential care settings. This is necessary to ensure that patients and service users are supported at all stages of the care journey and in the setting that is most appropriate to their needs.

To deliver on this and as part of the health service reform programme, seven Hospital Groups and nine Community Healthcare Organisations have now been established. Delivery of the National Clinical Programmes will take place through these new structures.

Ongoing improvements of our Health Services have a particular focus on:
a) key infrastructural changes such as Hospital Groups and Community Healthcare Organisations;
b) service improvements in areas such as integrated care and services for people with a disability; and
c) strategic enablers such as the individual health identifier. The following are the key reform programmes being progressed:

Continued developments of Hospital Groups, including the National Children’s Hospital.
Continued development of the Community Healthcare Organisations.
Strenghening of the clinically led, multidisciplinary, patient centred Integrated Models of Care Programmes.
Continue to develop and implement ICT reform in line with the eHealth Strategy under the leadership of the Chief Information Officer.
Strenghten our efforts to attract high quality staff to our Services, particularly in occupations such as medicine and nursing.
Continue to implement Healthy Ireland, which is our national framework for action to improve the health and wellbeing of the people of Ireland.
Continue to embed health and wellbeing goals and key performance indicators throughout all reform programmes for both staff and service users.

Interesting statistics

There are currently 108,225 people employed in the Public Health Service in Ireland. This includes the following Staff Category / Grade group breakdown:

a) 9,587 Medical/Dental

b) 35,534 Nurses

c) 15,109 Health and Social Care Professionals

d) 16,554 Management/ Administration

e) 9,444 General Support Staff

f) 19,648 Other Patient and Client Care

A significant number of people are also employed in the independent and private health care sectors, which includes GP practices, private hospitals and clinics.

Employees of the HSE bring a range of skills, talents, diverse thinking and experience to the organisation. The HSE is committed to creating a positive working environment whereby all employees inclusive of race, religion, ethnicity, gender, sexual orientation, responsibilities for dependents, age, physical or mental disability, civil status, membership of the Traveller community, and geographic location are respected, valued and can reach their full potential.

We aim to develop the workforce of the HSE which reflects the diversity of HSE service users, and which is strengthened through accommodating and valuing different perspectives, ultimately resulting in improved service-user experience.

Current skills shortages

Yes - there are certain career areas within the HSE that are currently experiencing skills shortages. It is anticipated that demand for these roles will only continue to grow.

These include:

Medical grades, including Consultant and Non Consultant Hospital Doctors (NCHD)
Health and Social Care Professionals and
Nursing grades.

Doctors

The main skills shortages are for NCHDs and Consultants in the areas of Emergency Medicine, Psychiatry, Respiratory Medicine, Radiology, Anaesthetics, Obstetrics and Gynaecology, Endocrinology and Geriatric Medicine, particularly in certain locations of the country.

There is also evidence of a significant undersupply of GPs in Ireland at present. By 2025, the predicted shortage of GPs here will potentially range from 493 to 1,380 due to increased levels of demand due to an ageing and rising population, as well as growth in eligibility for free GP care.

There is also evidence of a significant undersupply of GPs in Ireland at present.

Nursing In the Nursing area, there is a shortage of nurses in Theatre, Emergency Medicine, Midwifery, Disability and Mental Health.

All the approximately 2,000 nurses graduating this year will be able to access permanent jobs in hospitals across the country and other areas of the health service.

Health and Social Care Professionals

Due to an ageing population and a move to integrated care in the community as part of Sláintecare, it is anticipated that there will continue to be a growing demand for health and social care professionals, such as speech and language therapists, occupational therapists, physiotherapists, dietician, health care assistants and social workers.

There is also a continuous need for people to fill these positions within the disability services, with many opportunities to work within Children’s Disability Network Teams, for example.