The Irish Healthcare System

The Health Service Executive (HSE) provides public health and social services to the people of the Republic of Ireland through hospitals and community services across the country. The services delivered within these hospitals include scheduled care, unscheduled care, maternity services, outpatient services, and diagnostic services.

Learn more about the Irish health system and Health Service Executive (HSE).

Public hospitals in Ireland are organised into seven geographic hospital groups that provide acute care for patients.

Community healthcare organisations (CHOs) are responsible for the delivery of primary care and community-based services within local communities. These are typically services not provided by acute hospitals (for example, primary care, social care, mental health, and health and wellbeing services). There are nine CHOs in Ireland.

Following recommendations made in the 2017 Sláintecare report by the Oireachtas Committee on the Future of Healthcare, six new health regions are being introduced. These regional bodies will be responsible for the planning and delivery of integrated health and social care services. Transition to the new structure is expected to start in October 2024.

Individual hospitals within Ireland can be classified as:

• Health Service Executive (HSE) hospitals: hospitals owned and funded by the HSE.
• Voluntary public hospitals: hospitals that may be owned by private bodies (for example, a religious order) but receive state funding. Some voluntary public hospitals are incorporated by charter or statute and run by boards appointed by the Minister for Health.
• Private hospitals: hospitals that receive no state funding.

Depending on the services provided, public acute hospitals in Ireland are categorised as being a Model 1, 2, 3, or 4.

• Model 1 hospitals are community hospitals and do not provide surgical services.
• Model 2 hospitals admit low-acuity patients and typically have a minor injuries unit and carry out day care surgery.
• Model 3 hospitals provide both elective and general surgical services and admit undifferentiated medical and surgical patients. The hospital will have a category 1 or 2 ICU and may have an HDU. This hospital will have an AMAU. There will be an ED on-site and there may be a clinical decision unit (CDU) on-site as part of the ED service. There will be bi-directional flow of critical care patients between hospital Models 3 and 4.
• Model 4 hospitals are generally located in the larger metropolitan areas. These hospitals admit undifferentiated medical and surgical patients and take referrals from other hospitals, including tertiary referred patients. They provide complex specialist care and have a category 3 or 3S on-site ICU. There will be an AMU present, which is open on a continuous basis. There will be an ED, including a CDU, on-site.

Other public hospitals provide care to a particular cohort of patients or one specialism:

• Maternity
• Children (paediatrics)
• Orthopaedic (musculoskeletal)
• Eye and ear (ophthalmology/ear, nose, and throat (ENT))
• Cancer (radiation oncology)
• Rehabilitation