Health Service Executive

The Health Service Executive (HSE) was established by the Health Act 2004 and came into official operation on 1 January 2005. It replaced the ten regional Health Boards, the Eastern Regional Health Authority and a number of other different agencies and organisations. The Minister for Health retained overall responsibility for the Executive in Government. The HSE adopted a regional structure (HSE Dublin Mid-Leinster, HSE Dublin North East, HSE South and HSE West).

A new grouping of hospitals was announced by the Irish Minister for Health, Dr. James Reilly TD, in May 2013, as part of a restructure of Irish public hospitals and a goal of delivering better patient care:

Dublin North East (subsequently renamed RCSI Hospitals)

Dublin Midlands (subsequently renamed Dublin Midlands Hospital Group)

Dublin East (subsequently renamed Ireland East Hospital Group)

South/South West (subsequently renamed South/Southwest Hospital Group)

West/North West (subsequently renamed Saolta University Health Care Group)

Mid West (subsequently renamed UL Hospitals Group)

Criticism and Controversies

The HSE is frequently portrayed by the Irish media as an inefficient, top-heavy and excessively bureaucratic organisation. The Irish health system has been involved in a number of serious health scandals, for example relating to cancer misdiagnoses in 2008. The HSE has also been the subject of criticism for cutbacks, service cancellations etc., but has indicated that it is making good progress in saving costs and achieving its required 'break-even' budget position for 2010.

In the same month, the Irish Medical Organisation stated that patients awaiting a HSE medical card were waiting up to six months to receive their card, and that their health was being put at risk as they could not afford medicines that they would have otherwise obtained had they received their card. The HSE has since announced a new online system for medical card applications that will reduce turnaround time for routine applications to 15 days.

In May 2011, key forensic evidence in up to 25 sexual-assault cases may be challenged in court because of a major administrative blunder by the HSE. The victims – some as young as 14 – were told by Gardaí about the incident, in which a nurse who carried out their forensic tests was unregistered. This could lead to the evidence being challenged.

In May 2018, in the midst of the CervicalCheck misdiagnoses controversy, Tony O'Brien announced his resignation as director-general of the HSE with effect from close of business on 11 May.

An Ombudsman report in October 2020 found that children with suspected disabilities are encountering delays of many years in having their needs properly assessed. The report said that this is 'a serious and ongoing violation of their rights'.

2021 cyberattack

On 14 May 2021, the HSE suffered a major ransomware cyberattack which caused all of its IT systems nationwide to be shut down. It was the most significant cybercrime attack on an Irish state agency and the largest known attack against a health service computer system.