Ireland’s state of health

Projections of an ageing population and rising demand have pushed the Government to adopt a bold reform agenda on health, aiming to expand capacity, reduce waiting times, add to the workforce, and reshape care delivery.

Ireland’s health service now supports around 15,372 hospital inpatient beds, a 2.4 per cent increase since 2022. However, despite this incremental growth, there are roughly 716,573 patients currently on the active hospital scheduled care waiting list.

The Programme for Government 2025, Securing Ireland’s Future, and Autumn Legislation Programme reflect a multi-pronged approach aiming to bolster the workforce and infrastructure, expand hospital and community care capacity, reset waiting list standards, and invest in prevention, digital health, and patient-centred care.

Underpinning this ambition is recognition of structural strains and a realisation that without decisive action, even added beds and staff will struggle to keep pace. An earlier 2025 report from the Economic and Social Research Institute (ESRI) forecasts that by 2040, the State will need up to 6,800 additional inpatient beds in acute public hospitals, as a result of projected population growth, from 5.3 million to between 5.9 million and 6.3 million, and ageing, from one-in-seven aged 65+ to one-in-five.

In this context, the Government’s health agenda is as much about catching up as it is about preparing for future pressures.

At the heart of the plan is capacity expansion and waiting list reduction. The May 2025 waiting list report confirms that scheduled care lists remain high, but also that targeted policies are beginning to lead to incremental progress, with a 5 per cent reduction in the number of patients waiting over 12 months compared to the same time last year, and a 12 per cent drop for those waiting over 18 months.

In parallel, outpatient (OPD) attendances and inpatient/day-case (IPDC) attendances increased by between 9 per cent and 10 per cent and between 4 per cent and 5 per cent, respectively, over 2024/2025, signalling a ramping up of hospital activity.

However, despite the increase in bed capacity, more than 1,122 public hospital beds remain temporarily closed or delayed in opening due to staffing shortages, construction delays, or regulatory compliance issues.

Emergency and urgent care are also cited as priorities. Overcrowding remains a visible symptom as, on many days in 2025, more than 600 patients nationwide were reported waiting on trolleys for beds. The Government is aiming for seven-day care, increased consultants, improved after-hours rostering, and expanded diagnostics, aiming to reduce both demand surges and cancellations.

In tandem, workforce expansion is a cornerstone. The plan envisages scaling up recruitment of doctors, nurses, allied health professionals, and consultants, aiming to reduce reliance on agency staff, expanding public-only consultant posts, and growing training capacity in medical, nursing, dental, pharmacy, and allied health courses. By investing in supply and retention, the Government aims to avoid the familiar cycle of “beds built, but no staff to operate them”.

However, capacity and staffing are only part of the equation. The 2025 agenda also embraces system reform, patient-centred care, and better governance. Legislative proposals in the autumn 2025 package include bills on patient safeguarding, reform of prescribing and pharmacy practices, and a National Research Ethics Bill, indicating a structural commitment to modernise how healthcare is regulated and delivered.

Meanwhile, on care delivery, the governance of waiting list performance is being tightened. The 2025 multi-annual Waiting List Action Plan (WLAP) aims to embed new operational standards and transparent metrics. There is also growing recognition of the need for long-term care, post-acute care, and community supports.

Delayed discharges remain a persistent challenge. By August 2025, more than 5,500 patients had stayed in hospital longer than medically necessary, occupying beds while awaiting homecare, residential care, or community supports, resulting in over 85,000 lost bed days. Until such bottlenecks are addressed, through expanded community supports, better home care provision, and faster transitions, there is consensus in the sector that adding hospital capacity alone will not resolve overcrowding or waiting list pressures.

The ESRI’s 2040 projections make clear that the current expansion is necessary but not sufficient. Outpatient attendances, inpatient discharges, and bed day demand are all set to grow by between 20 per cent and 60 per cent over the next 15 years, meaning that increasing the number of beds and staffing is critical.

Minister for Health Jennifer Carroll MacNeill TD has described her main task as “continuing to extend our hospital and care capacity”. She adds: “We are committed to ensuring there are more beds for our hospitals and to removing some elective procedures from acute hospitals into new surgical hubs, and then elective hospitals.”