What does the HSE do?
If a clinic appointment is delayed, the HSE manages service delivery; a question about national funding or policy belongs with the Minister and Department.
The Minister and Department
- Set national policy and propose legislation
- Seek funding through the Budget process
- Answer to the Dáil for Government policy
The HSE
- Organises and delivers public health and social care services
- Manages services, staff and resources within its remit
- Publishes service information and responds to complaints
- Runs public hospitals and community health services.
- Operates the National Ambulance Service.
- Administers the medical card, GP visit card and other schemes.
- Provides mental health, disability and older-person services, including home support and the Nursing Homes Support Scheme.
- Runs public health programmes such as vaccination and screening.
Most GPs are private contractors who provide public services under agreements with the HSE. The HSE also funds many voluntary hospitals and community organisations.
The six health regions
From 1 March 2024 the HSE has organised service delivery into six regions, each led by a Regional Executive Officer: Dublin and North East, Dublin and Midlands, Dublin and South East, South West, Mid West, and West and North West. The change is part of Sláintecare, the long-term plan for reforming Irish health services agreed by an Oireachtas committee in 2017.
Anne O’Connor took over as the HSE’s top executive on 23 March 2026 after Bernard Gloster retired.
Who is in charge: the HSE or the Minister?
| Body | Role |
|---|---|
| Minister for Health | Sets national health policy, answers to the Dáil, and secures funding in the Budget. |
| Department of Health | Advises the Minister and drafts health legislation. |
| HSE | Delivers public health services and manages its budget and staff. |
| HIQA | Independently inspects and sets standards for health and social care. |
| NTPF | Buys extra treatment for public patients and publishes waiting-list data. |
| Oireachtas | Passes health laws and holds the Minister and HSE to account through the Health Committee, Public Accounts Committee and questions. |
That split explains why blame is often argued between the Government and the HSE. The Minister sets funding and policy; the HSE decides how to spend and staff within it.Accountability bodies in Ireland.
Where do waiting lists fit in?
Hospital waiting lists are published by the National Treatment Purchase Fund. Your local TD can raise a delay with the Minister but cannot change your appointment date.Who is responsible for hospital waiting lists?.
The HSE’s budget is one of the largest items in the annual Budget, and overspends are regularly debated in the Dáil.How the Budget works.
How do you raise a problem with the HSE?
If something goes wrong with a public health service, there is a formal route before you contact a TD.
Speak to the service first
Many problems can be sorted by the staff or manager of the hospital, clinic or service involved.
Use Your Service, Your Say
This is the HSE’s formal process for complaints, comments and compliments. You can submit online, by email or by post.
Go to the Ombudsman if needed
If you are not happy with the HSE’s response, the Office of the Ombudsman can examine complaints about public health services.
Contact a TD for help or scrutiny
A TD can make representations or ask the Minister a parliamentary question, and the answer is published.
What the HSE is and is not responsible for
Common assumption: The HSE decides health policy.
In fact: Policy and the overall budget are set by the Minister for Health and the Department. The HSE runs services within that framework.
Common assumption: Every public hospital is run by the HSE.
In fact: Some large hospitals are voluntary hospitals with their own boards. They are funded by the HSE but managed separately.
Common assumption: The HSE regulates doctors and nurses.
In fact: Professional regulation is done by separate bodies, such as the Medical Council and the Nursing and Midwifery Board of Ireland.