Appointees to new HSE manager tier could earn more than €250,000 a year

New managerial tier in the HSE to be paid more than hospital managers in current health system

Appointees to a new managerial tier in the HSE could earn more than €250,000 a year, significantly more than hospital managers currently earn, under a plan developed by Minister for Health Stephen Donnelly.

Under the new plan, those heading up the six new HSE Health Regions being rolled out under Sláintecare will be paid up to €257,000 each.

The Government believes the higher salaries are needed to retain and attract top-class healthcare managers, with salaries aligned to the pay scale in the new consultant contract signed off last year.

The salaries are significantly higher than those currently paid to the existing six hospital group managers and nine community healthcare organisation chief officers, who are paid between €110,00 and €175,000 annually.


The existing roles will be stood down as the six new Regional Executive Officers (REOs) and their teams are being established. Each of the six will be responsible for managing multibillion-euro budgets and tens of thousands of staff.

The new pay scales have been approved by the Department of Public Expenditure in recent weeks, with Government sources saying publication of a new implementation plan for the HSE health regions is “imminent”.

The new deal, which will make those on the top end of the scale among the best-paid public servants in the country, comes as preparations are under way for negotiations on a new public pay deal, with the Building Momentum deal running out at the end of the year.

Healthcare unions are likely to use the development to push for bigger rises, while it is also likely to be watched closely elsewhere at the top of the civil and public service.

Government sources say a number of public hospital managers have been poached by private hospitals in recent years, where they believe pay is higher. Following a report given to the Coalition earlier this year, the Government established a review body to examine the question of pay increases for senior public servants.

Mr Donnelly flagged his intention to link the pay of the new tier of top managers to consultants in an interview late last year, saying “parity” between the two would “be very important”.

“My view is we don’t pay our hospital managers enough,” he told the Sunday Business Post. “We pay them less than other countries pay them.”

“Why would we pay all of the doctors in a hospital a particular wage? And then the person tasked with actually running the hospital and managing all of those people, pay them a fraction of what we pay all of the doctors. That never made any sense to me,” he said on the podcast published in November 2022.

He also said that the manager “needs to be able to command the respect of the clinicians ... and if you’re paying them a half or two-thirds of what you’re paying the doctors [that is] much harder for them.”

Jack Horgan-Jones

Jack Horgan-Jones

Jack Horgan-Jones is a Political Correspondent with The Irish Times