Industry warns 10% cost increase unsustainable as pay gap with HSE widens
Ireland’s private healthcare sector is heading toward a major crisis as firms struggle with rising wages and severe staff shortages, according to the Excel Healthcare Salary Guide for 2026.
The new minimum wage increase to €14.15 per hour from January, combined with higher salary requirements for foreign workers, will impose an unsustainable burden on nursing homes and private healthcare providers. Industry analysts estimate costs will increase by up to 10 percent.
The problem is compounded by unfilled vacancies for nurses and healthcare assistants, even after the HSE recruitment ban was lifted. The public-private pay gap has widened to between 15 and 20 percent in many frontline roles, while competition among private employers intensifies. Staff transfers from care homes to the HSE represent another significant challenge.
The nursing sector and related services face particular difficulties, with providers unable to meet candidates’ expectations regarding pay, flexibility and workload. The average salary for nurses now ranges between €44,000 and €48,000, while healthcare assistants with experience can earn between €33,000 and €36,000.
In the private sector, senior healthcare assistants are expected to earn €20 per hour by 2026, up from the current €17.50. While the increase may help retain staff, industry representatives warn that rising operating costs will place severe pressure on smaller organizations. The guide indicates directors of nursing will earn €98,000 in 2026, an increase of €3,000 from 2025.
Nursing homes face particular pressure in attracting and retaining overseas staff. Several small nursing homes have recently closed due to inability to comply with Fair Deal scheme requirements.
The Economic and Social Research Institute predicts Ireland will need 60 percent more long-term care beds and home supports by 2040. Nursing Homes Ireland and The Alliance have called for revised government funding, seeking an additional €160 million to €170 million annually for the cost of care model. Without increased funding, operators warn they will struggle to maintain sustainable services.
The Nursing and Midwifery Board of Ireland reports 92,385 registered nurses and midwives, a 3 percent increase on the previous year and the largest increase in its history. The number practicing and registered has also grown, with 86,948 nurses and midwives currently practicing, up 3 percent.
The guide identifies work-life balance as a key factor in career choices, with more staff moving into step-down, community and home care roles. Recruitment and retention are becoming increasingly difficult due to the 50:50 non-EU staffing rule, visa challenges and the housing shortage.
The private healthcare sector’s crisis highlights tensions between efforts to improve worker pay and conditions and the financial sustainability of care providers, particularly smaller operators. With Ireland’s aging population requiring significantly expanded long-term care capacity in coming decades, the sector’s viability has become a critical policy challenge requiring urgent government attention and potential intervention.