Minister for Health publishes The Path to Universal Healthcare – Sláintecare & Programme for Government 2025+ (Sláintecare 2025+)

Sláintecare 2025+ aims to forge the way towards accessible, affordable, high-quality, healthcare for the people of Ireland when they need it, where they need it. 

Minister Carroll MacNeill stated: 

Significant investment in healthcare infrastructure and workforce is being made to ensure the long-term demographic challenges and deficit in health and social care infrastructure Ireland faces are addressed. 

Improving Service Quality is a critical Sláintecare priority across a number of service areas. Public Health, Prevention and Promotion will play a significant role in improving the overall health of the population, including through measures designed to promote healthy lifestyles, address mental health difficulties and reduce inequalities. 

The new plan will focus on enabling reform measures critical to the successful delivery of Sláintecare. The digital health strategy will empower both workforce and patients to use new technologies such as the HSE’s new Health App. Realising the ambition set out in this strategy will not be possible without the ongoing and greatly valued expertise and dedication of the entire health and social care workforce.

Minister Carroll MacNeill said: 

SC2025+ will bring a new patient focus to services that are both affordable and of the highest quality and where the patient is at the centre of all our collective efforts.

The Minister today also published the Sláintecare Implementation Progress Report 2024, noting the ongoing progress made in transforming our health and social care services to provide the Right Care, in the Right Place, at the Right Time. 

There has been a significant reduction in the cumulative daily 8.00am trolley count over 2024, with numbers down 11% compared to 2023, despite an 8% increase in the number of patients presenting to Emergency Departments. The volume of weekend discharges (Friday - Sunday) from acute hospital beds increased by 15%* in 2024 compared to 2023, while total discharges increased by approximately 12%.

In relation to reforming and expanding care into the community, Minister Carroll MacNeill said:

The six new HSE Health Regions commenced in March 2024 and the six Regional Executive Officers (REOs) are now fully accountable and responsible for the planning and delivery of integrated care for their respective populations. 

2024 saw the publication of ‘Digital for Care 2030: A Digital Health Framework for Ireland 2024-2030’ setting out a vision that aims for better health outcomes enabled by seamless, safe, secure, and connected digital health services, which supports health and wellbeing for both our patients and providers. 

*St Vincent’s and Wexford excluded from calculations

Sláintecare 2025+ sets out an integrated and whole of system reform programme to be implemented over the period 2025–2027, recognising that some of these reforms will continue over a longer timeframe. Sláintecare 2025+ is designed to address challenges in the health service and builds on the progress made in implementing successive Programmes for Government and Sláintecare Implementation Strategies between 2018 and 2024. It is an ambitious and multifaceted programme designed to move Ireland towards a universal healthcare service. It has been developed following extensive stakeholder engagement and under the direction and oversight of the Sláintecare Programme Board. The overriding goal of Sláintecare 2025+ is to improve health and social care services in Ireland, to optimise patient outcomes and be responsive to their needs.

Sláintecare 2025+, incorporating the principles of Healthy Ireland under its Healthy Living pillar, is designed to support people to live well and choose healthy lifestyle behaviours, and to make access to healthcare services fairer and faster by expanding and integrating care in the community, increasing capacity and output of services through workforce reforms, developing a modern digital health infrastructure, and driving productivity improvements.

Sláintecare 2025+ sets out 23 individual Sláintecare Projects and the milestones to be achieved on the path to achieving universal healthcare across three priority areas:

• improving access to health and social care services
• improving service quality for patients and service users
• increasing capacity of the health and social care service

Underpinning the delivery of Sláintecare projects across these three areas, are critical enabling reform programmes. These are designed to transform the delivery of health and social care services through digital transformation and innovation with an increased focus on achieving greater levels of productivity. The new HSE Health Regions is a particular enabling reform that will reorganise the overall health and social care service to one better aligned to meet the specific needs of the population. 

Over the course of the implementation of Sláintecare 2025+ patient experience and outcomes will further improve by:

Improving access

• further reducing waiting times in hospitals and the community
• improving the presence in our hospitals of the requisite medical expertise, through the continued rollout of the Sláintecare Consultant Contract, permitting public-only work in public hospitals
• improving local capacity with the continued delivery of Primary Care Centres. There are 5 more in construction and a total of 179 currently operational
• increasing activity levels in Enhanced Community Care Programme services with target delivery of 1,626,435 patients to be seen through the Community Healthcare Networks in 2025; 141,000 patient contacts by Community Specialist Teams for Older Persons (ICPOP) and 334,000 patient contacts by Community Specialist Teams for Chronic Disease (ICPCD), an increase of 46% on 2024’s target
• increasing access and affordability of healthcare services via the significant programme of work relating to eligibility measures is currently being undertaken. The primary goal is to complete a comprehensive review and appraisal of the arrangements that underpin the existing eligibility framework. This will enable the development of evidence-based policy options for a future eligibility framework to support a progressive move towards universal healthcare

Improving quality

• improving Person-Centred Care and Patient Safety, with the National Patient Safety Office (NSPO), working alongside our patient safety colleagues in the HSE, in building a systematic approach to patient safety, promoting the delivery of safe and high-quality health, and improving the patient experience
• four new communities are being added to the Sláintecare Healthy Communities Programme (SHC)
• the Publishing and implementation of the new National Sexual Health Strategy
• the Publishing of the implementation plan for the National Mental Health Promotion Plan
• continuing to reform Disability Services away from traditional models and towards the community, as well as further increasing capacity
• the implementation of Sharing the Vision: A Mental Health Policy for Everyone will improve and enhance mental health services and supports for the whole population, from promotion, prevention and early intervention to specialist mental health service delivery, guided by the Implementation Plan (2025-2027)
• in 2025, development of successor policy to Connecting for Life, Ireland’s national suicide reduction strategy
• there will be continued focus on delivering key women’s health initiatives that women, clinicians, and stakeholders have prioritised including an emphasis on delivering care in the community and investing in key areas for minority groups. They include Healthy Ireland initiatives that focus on period and hygiene poverty mitigation measures, extended access to the free contraception scheme and the continued expansion of ambulatory gynaecology clinics, post-natal hubs, and increase the hours within specialist menopause clinics
• the delivery of the National Oral Health Policy, Smile agus Sláinte, will fundamentally reform and modernise the provision of oral healthcare services. The implementation of the Policy will substantially enhance access to modernised public oral healthcare services

Building capacity

• further developing and modernising health infrastructure to ensure that our assets, both physical and digital, are fit-for-purpose and support the drive to improve health outcomes and experiences for patients and those who give them care. As outlined in the Programme for Government, we are delivering a significant programme of work through our capital programme including:
  • establishing six surgical hubs in Cork, Dublin (2 sites - the first of which was opened in Mount Carmel in February 2025), Galway, Limerick and Waterford, and exploring the provision of an additional surgical hub for the North-West
  • building four new elective treatment centres (Cork, Dublin (2 sites) and Galway) At the end of 2024 an Integrated Design Team was appointed to provide architectural, design and engineering services and a Project Control Team to support the HSE to manage, control and administer the design/construction programme. The total additional capacity to be provided by the Elective Treatment Centres is estimated to be 977,700 annually
  • expanding trauma services, including facilities in Dublin, Cork and Galway
• improving Strategic Workforce Planning to ensure the right healthcare worker is available in the right place, at the right time. This will assist in fully operationalising capital projects such as the Major Trauma Centres in the Mater Misericordiae University Hospital and Cork University Hospital
• publishing a strategic review of general practice identifying the challenges facing General Practice in delivering a sustainable service into the future. This will set out the actions necessary to address those challenges in the context of delivering the principles of Sláintecare

Enabling reform

• Digital Health Transformation will improve health outcomes by enabling safe, secure and connected digital health. Implementation of the digital health strategy, Digital for Care – Strategic Digital Health and Social Care Framework (2024-2030) will be critical in connecting health information and data. This will improve communications and efficiency and, most importantly, patient experience in our health and social care service
• the Productivity and Savings Taskforce, established in January 2024, will continue to drive a programme of work designed to achieve savings and efficiencies across the HSE to optimise the use of health funding through the delivery of safe health services to as many people as possible in a timely manner

Sláintecare Progress 2024

Significant levels of reform continued to be delivered in 2024, building on the milestones achieved in the Sláintecare Progress Report 2021-2023: 

Improving access

• Urgent & Emergency Care: Significant reductions in the cumulative daily trolley count in 2024, with numbers down 11% vis a vis 2023 despite an 8% increase in the number of patients presenting to Emergency Departments
• Waiting Times: There has been an approximately 12% reduction in the total number of patients waiting over 12 months since December 2023, and a corresponding reduction of approximately 20% in the number waiting over 18 months. As a result of these improvements, as of the end of December 2024, approximately 85% of all patients who were waiting for care at the start of 2024 have been removed from the waiting list
• more hospital beds than ever before: Since 2020, 1,195 new acute inpatient beds have been added, with plans for further expansion
• increase in Residential Care Beds: €13.7 million was allocated in 2024 to deliver 985 community beds (long-term and short-term) in residential care settings. 871 beds were delivered by the end of 2024
• Enhanced Community Care (ECC) Programme: 95% of GPs have signed up to the Chronic Disease Management (CDM) programme and there were over 645,000 patient reviews by GPs in 2024. 92% of patients with chronic disease are now fully managed routinely in primary care and are not attending hospital for ongoing management of their chronic condition
• Primary Care Centres: By the end of 2024, there were 179 Primary Care Centres (PCCs) operational nationally. 50 PCCs have been opened between 2020 and 2024
• Public-Only Consultant Contract (POCC): This was approved by Government in December 2022 and launched in March 2023. As of the 11 December 2024, there were 2,770 consultants who had signed the POCC; this is made up of 728 new entrants and 2,042 change of contracts
• eligibility: In July 2024, the free contraception scheme for women was expanded to include all those aged 17-35. With nearly 2,400 GPs and 2,050 pharmacies participating, approximately 88,000 individuals used the scheme from September to December 2022, over 189,000 in 2023, and just under 287,000 from January to November 2024

Free access to Assisted Human Reproduction (AHR) Treatment: Referrals for publicly funded AHR treatment began in September 2023. By 9 May 2025, over 2,450 couples were referred for AHR services.

Improving service quality

• the Healthy Ireland Survey 2024 highlighted that 81% of the population report being in overall good or very good health, remaining broadly unchanged since 2023 (80%). Two in every five people (41%) have a long-term health condition confirmed by a medical professional, broadly unchanged since 2023 (40%)
• National Men’s Health Action Plan— Healthy Ireland - Men (HI- M) 2024 – 2028 was published in November 2024
• National Mental Health Promotion Plan- Pathway to Wellbeing published in December 2024

Building capacity

• Strategic Workforce Planning and Workforce Reform: The number of consultants employed by the health service has increased from 3,226 WTE in 2019 to 4,601 at the end of January 2025, a 42% increase
• the Acute Inpatient Bed Capacity Expansion Plan was published in 2024 setting out a total planned capacity for delivery of 3,438 additional new acute inpatient beds and 929 replacement acute inpatient beds over the period 2024 to 2031
• Elective Treatment Centres: Preferred sites for Elective Treatment Centres in Dublin at Connolly Hospital and the current Children’s Hospital in Crumlin were identified during 2024. These are in addition to the sites previously identified for Cork (at St Stephens Hospital) and Galway (at Merlin Park)

Enabling reform

• HSE Health Regions: Health Regions commenced on 4 March 2024 and all six REOs were in post by April 2024. Each Integrated Healthcare Area provides local services within its Health Region, serving a population of between 120,000 and 420,000 people. Hospital Groups and Community Health Organisations (CHOs) were stood down from 1 October 2024
• Digital Health: Digital for Care 2030: A Digital Health Framework for Ireland 2024-2030 was published in May 2024
• HSE Patient App: Up to 1,500 patients trialled the HSE’s new patient app in late 2024, ahead of wider roll-out planned for 2025
• National Shared Care Record: The National Shared Care Record (SCR) will enable the health service to gather patient data from primary, community and acute settings and present it as one unified digital health record. Procurement of the technical platform to support the development of the shared care record was completed in 2024
• National Electronic Health Record Programme: A new integrated National Electronic Health Record (EHR) programme has commenced with the initial focus on developing the preliminary business case and procurement strategy
• Acute Virtual Wards (VW): These are now live in two HSE Health Regions (Limerick in the Mid-West and St Vincent’s in Dublin Southeast). Four more are planned for delivery in 2025
• Creating a Culture of Innovation: 16 projects were funded to test as a proof of concept in 2024 under Rounds 2 & 3 of the Sláintecare Integration Innovation Fund (SIIF). The priority themes for SIIF funded projects in 2024 included: Digital Innovation in service delivery, Workforce Reform, New Models of Integrated Care and Improving Oversight and Partnership in the health sector
• Productivity and Savings Task Force: This was established in January 2024, to achieve savings and efficiencies across the HSE and optimise the use of health funding by delivering safe health services to as many people as possible in a timely way. By achieving an overall expenditure outturn within the revised expenditure limits in 2024, the HSE achieved its full €251 million savings target for 2024