Elective Care (Elective Treatment Centres and Surgical Hubs)

The Government is fully committed to the delivery of a world-class health and social care service where everyone has timely access to quality care. A crucial part of this is the development of elective care services - i.e. for routine treatments, procedures or consultations which are scheduled in advance for non-emergency issues.

We are increasing elective-only day-case capacity through the Elective Ambulatory Care Programme. This is being delivered in two phases: a national network of surgical hubs in the first instance to meet medium-term demand and capacity, and, in the longer term, a network of Elective Treatment Centres in Cork, Dublin and Galway.

All of these new elective treatment facilities will support the separation of scheduled (elective) and non-scheduled (emergency) care, leading to improved care for patients as recommended in the 2017 cross-party Sláintecare Report and subsequent Government policy.

There is significant international evidence which supports the separation of unscheduled and scheduled care for improving services for all patients.

The separation of care leads to fewer cancellations and fewer delays for elective care caused by seasonal surges, localised outbreaks, and surges in emergency attendances. Reducing waiting times for elective cases can help to avoid patient conditions from deteriorating further while waiting for treatment. Providing additional elective care capacity will therefore lead to better health outcomes and improved quality of life for those individuals being treated and for their families.

Developing increased elective care capacity will also release capacity in existing hospitals, allowing them to focus on non-elective, acute and other inpatient activity.

Through the Elective Ambulatory Care Programme, we are delivering a national network of elective care by developing new Surgical Hubs and Elective Treatment Centres, allowing us to address current and future health capacity needs. These will provide national coverage, with over 97% of the population within 90kms of one of these new facilities.

Elective facilities are designed to deliver expert, high-volume, low-complexity day procedures, without overnight stays. They are not providing surgical care for emergency or complex cases; and patients will arrive and leave on the same day (i.e. they will not have in-patient beds for overnight stays).

The Surgical Hubs and Elective Treatment Centres will deliver care and consultations across 12 Specialties:

• Gastroenterology
• General Surgery
• Gynaecology
• Ophthalmology
• Orthopaedics
• ENT
• Pain Relief
• Plastic Surgery
• Urology & Vascular Surgery
• Dermatology
• Maxillofacial

These new elective facilities will support the Government’s aim of reducing waiting times for elective procedures in line with Sláintecare targets (i.e. 10 weeks wait for an outpatient appointment and 12 weeks for a day case procedure). To this end, they will be accessible by all patients and hospitals/consultants within and across the health regions. Further, in line with Sláintecare principles, these elective facilities are providing services and treatment to public patients only, i.e. there will be no private practice permitted.

The new Surgical Hubs will address the demand for elective care capacity in the short to medium term. The hubs are based on the successful Reeves Day Surgery Unit in Tallaght. Opened in 2020 this surgical hub achieved significant reductions in day case wait times for certain day-case elective procedures.

The Mount Carmel surgical hub (South Dublin) opened in February 2025 and delivered a total of 3,729 procedures in 2025 (24% above its target for the year), resulting in a 74% reduction of patients waiting more than 12 months on relevant waiting lists compared to December 2024. This hub also allowed for the introduction of innovative patient care pathways and freed up significant theatre capacity in St James’s hospital.

In addition to existing Tallaght and Mount Carmel hubs, five further surgical hubs are expected to become operational over the course of 2026 in North Dublin, Cork, Galway, Limerick and Waterford. Two further hubs are also being developed in Sligo and Letterkenny to ensure coverage for the northwest; these are now in the planning stage.

When fully operational each hub is expected to deliver additional annual activity of between circa 4,000- and 8,000-day case procedures, 5,700 minor ops procedures and up to 18,500 OPD appointments.

Alongside the delivery of the Surgical Hubs, planning is underway for new larger national Elective Treatment Centres (also referred to as Elective Hospitals) in Cork (St Stephen’s Hospital, Glanmire), Galway (Merlin Park) and Dublin (sites at Connolly Hospital in Blanchardstown and Children’s Health Ireland, Crumlin), which will meet our longer-term elective care capacity requirements.

Detailed design for the Elective Treatment Centres in Cork and Galway is underway. Relevant surveys and site investigations have been conducted. The HSE is also progressing enabling packages and engaging with statutory planning authorities to prepare the necessary planning permission applications and to progress these centres to shovel-readiness. The HSE expects to lodge planning applications for Galway and Cork in 2026.

In relation to Dublin, demand modelling is underway, ahead of detailed design. This modelling includes an assessment of current capacity/infrastructure and how it can be best utilised to meet future capacity needs. The impact of the surgical hubs in Dublin as well as other existing facilities and future requirements are being considered as part of this process. On conclusion of this demand modelling work, the Preliminary Business Case for Dublin will be finalised.