The Year in Review

The Department of Health requested €18.3 billion in gross funding for 2020. Compared to Revised Estimates 2019, this was a €1.2 billion increase in spending.

Using the Indicative Appendices to the Health Vote, we can get an indication of where the additional resources were directed. Already the largest service area, Acute Hospitals received the largest increase, further increasing its share of the health budget. Mental Health received a very small share of the change in overall terms, but this is the result of a €46.5 million fall in capital budgets, which offsets current spending that is expected to rise by €51.3 million.

The HSE budget for 2021 will see an increase of €3.5bn bring the total budget to €20,623bn as the healthcare system continues to reckon with the Covid-19 pandemic.
Around half of this increase (€1.68bn) will go towards Covid-19 spending while the remaining €1.8bn will go towards non-Covid care.
The National Service Plan for 2021 will include additional spending to improve services in the areas of cancer, maternity and mental health.
The plan provides for 16,000 additional staff including 1,100 medical and dental staff, more than 3,500 nurses and midwives and 4,000 health and social care professionals.
The funding for Covid-related spending includes PPE, the vaccination programme, testing and tracing and improving access to care.
HSE Chief Paul Reid said: “The need to adapt our services urgently to the requirements imposed by the pandemic has led to some rapid changes, such as a move to increasing the volume and variety of services provided in the community.
“In 2021, we hope to use the additional funding to reinforce and support this move, which is in line with the Sláintecare reform agenda.”
€1.1bn of the additional investment for 2021 will be used to deliver permanent and enduring improvements in healthcare arising from the Sláintecare reform programme while €0.7bn will go towards covering the increased costs of providing existing levels of service.

Employment growth

Despite considerable demand for those employed in healthcare occupations as a result of COVID-19, overall employment growth for this group was below the national average for the period 2015 to 2020.
However, demand has been evident, with these occupations accounting for 30% of all new employment permits issued in 2020 (primarily related to nurses and doctors) with a further expansion of the occupations in the employment permit system encompassing therapists and healthcare professional roles.
The HSE have also announced the creation of 16,000 whole time equivalent (WTE) posts in 2021. However, despite this demand, at least 5,000 persons employed in the health sector were in receipt of income support payments (PUP and EWSS combined) in June 2021; without any occupational breakdown available it is not possible to determine who this relates to although it is likely that the majority are based outside the hospital/nursing home setting. Due to Ireland’s ageing demographics demand for health services is expected to continue to grow in future years.

The healthcare industry is facing many changes that pose new challenges to medical organisations big and small. In particular, the fast-evolving government regulations, Covid-19 Pandemic recovery, technological innovations, and patient expectations.


Sláintecare is the ten-year programme to transform our health and social care services. It is the roadmap for building a world-class health and social care service for the Irish people.
Sláintecare sets out this new vision for the delivery of Introduction from the National Service Plan 2020 healthcare in Ireland.
Sláintecare will feature prominently in our forthcoming corporate plan, in all our future planning exercises and also in our operational decision-making. For the coming year, it has been agreed that that Sláintecare will focus on two key priorities:

  1. Capacity and Access – They will work to improve access to services, to reduce waiting lists and hospital overcrowding (this will be a three-year plan); and
  2. Regional Health Areas – working with the Department of Health (DoH), they will start to design and implement the new organisational structures at national, regional and local levels.
    Sláintecare has also informed many of the priorities in this year’s NSP.
    In 2020 they committed to do the following:
    • Continue with the disability sector reform programme
    • Extend Activity Based Funding (ABF), including within the community setting
    • Develop and implement a governance and oversight model between the HSE and the DoH
    • Continue with our efficiency programme, with a targeted 1% (circa €170 million (m)) improvement
    • Push forward on the use of generic drugs and biosimilars
    • Progress electronic health record project for Children’s Health Ireland
    • Implement and adhere to the Pay and Numbers Strategy 2020
    • Maintain focus on our preparations for Brexit
    • Maximise value with the entirety of the resources provided by the Minister