HCA Literature Review
This brief outlines key challenges facing Ireland’s Healthcare Assistant workforce and highlights urgent policy opportunities. The HCA role lacks a clear national definition, leading to confusion, role overlap with nursing staff, and wide variation in duties across sectors. Regulation is fragmented, with no unified registration system or mandatory qualifications, resulting in inconsistent pay, conditions, and standards, particularly between public and private providers.
While QQI Level 5 is recognised as the standard qualification, training provision varies widely in content, cost, and delivery. Many HCAs, especially in the private sector, remain unqualified or partially qualified due to financial barriers and restrictive work permits that limit mobility. Private providers rely heavily on overseas recruitment and weaker enforcement of qualifications, yet struggle with retention as qualified HCAs move to better-paid public roles. Pay disparities, wage stagnation linked to minimum salary rules for non-EU workers, and flat pay scales further reduce job attractiveness and discourage skill development.
These issues pose serious risks to workforce stability and care quality at a time of rising demand from an ageing population. Addressing them will require stronger regulation, consistent education standards, clear career pathways, and better professional support.
Key policy actions include establishing a nationally standardised HCA role, introducing professional registration and unified regulation, mandating QQI Level 5 with a consistent national curriculum, creating structured career pathways with differentiated pay, enabling collective bargaining rights, supporting professional networks, and expanding research on private sector conditions, union roles, and delegated clinical duties.
