Patients across Ireland must not pay the price for abolition of insourcing, warns IHCA
IHCA calls on Minister for Health and HSE to urgently set out national plan to replace lost capacity
The Irish Hospital Consultants Association (IHCA) has today (22.07.26) called for urgent clarity on how patient capacity lost following the abolition of insourcing will be replaced. The Association is calling on the Minister for Health and the HSE to outline what replacement capacity will be provided and set a clear timeline for delivery.
Insourcing has now ended across all HSE regions, despite an internal HSE report warning that its abolition could create a “significant risk of unintended harm to patients”. The confidential report, revealed today by The Irish Times, examined the impact on the West and North West region. It covers six acute hospitals across Galway, Mayo, Sligo and Donegal. The report warned that ending insourcing could increase outpatient waiting lists in the region by between 2,000 and 4,000 patients every month.
The report described insourcing as a “critical enabler” of service delivery across the region, accounting for 13% of new outpatient activity in 2024. This fell slightly to 11% in 2025, while insourcing also accounted for 20% of the region’s endoscopy capacity. It warned that without replacement capacity, “this reduction cannot be absorbed within existing core hours”.
The IHCA said that while today’s report relates to one region, insourcing was used across the country and has now ended nationally. The Association said there is no reason to believe the impact on patients in other regions will be any less significant. If one region alone projects up to 4,000 additional patients joining waiting lists monthly, the cumulative impact across all regions could be considerably greater. It called on the Minister to publish equivalent data for every HSE region, allowing the full national impact of ending insourcing to be understood.
Commenting, IHCA President Professor Gabrielle Colleran said: “Insourcing was helping patients. That is the starting point for this conversation and a fact that has been almost entirely lost in the political and media debate of recent months. Consultants were coming in on their own time, outside contracted hours, to see patients who had already been waiting too long for care.
“The HSE’s own internal report warned in writing that ending insourcing without replacement capacity would create a significant risk of unintended harm to patients. The question patients now need answered is simple: what is the plan? What replaces this capacity, and by when?
“Patients should not become unintended casualties of policy decisions. More than one million people are already on waiting lists nationally. We cannot afford to see thousands more patients added every month because capacity has been removed without a clear plan to replace it.”
Professor Colleran added: “Ireland continues to have too few consultants and insufficient protected capacity across outpatient clinics, diagnostics and operating theatres. We also continue to face inadequate investment in hospital infrastructure. Until these underlying issues are addressed, patients will continue to experience unacceptable delays, regardless of which short-term initiatives are introduced or withdrawn.
“I am also deeply concerned about what the narrative of recent months has done to the consultants who participated in insourcing in good faith. The commentary has created a climate in which work that was genuinely helping patients has come to be viewed as inappropriate. Many of our members are now reluctant to be associated with work they should be proud of. That is an unintended but very real consequence of this debate.”
The IHCA noted that waiting lists in Ireland have already reached a record high of more than one million people. Rural and peripheral communities, where patients have fewer alternative healthcare options, are particularly vulnerable to any reduction in access to care.
ENDS
Media contact
Lorna Fitzpatrick, Tel: 087-2763941 / Email: l.fitzpatrick@fentonfitzwilliam.com.