Morale among Health and Social Care Workers
At a time when Ireland’s health and social care system is undergoing huge changes, morale among workers is of vital importance. The Sláintecare report promised universal healthcare and offered a vision of a more community-centred model of provision that can both offset the strain on acute care and better suit the needs of our growing and ageing population. Instead, the workers needed to deliver these changes feel unsupported and underappreciated at the front line of a health and social care system that continues to underperform by international standards. The current situation is a result of Ireland’s long-term failure to invest properly in public health and social care, exacerbated by a recent series of crises, from the cuts made in the aftermath of the 2008 financial crash, to the 2020 Covid-19 pandemic and 2021 ransomware attack.
This report is based on research conducted by the Think Tank for Action on Social Change (TASC), led by report author and primary researcher Tiarnán McDonough, with members of the Fórsa Health and Welfare Division. In March and April 2025, 3,775 workers responded to an online survey, and 24 workers from across the country took part in focus groups. The division’s membership represents a wide range of workers, within the health and social care sector. This includes clerical and administrative roles, as well as health and social care professionals in clinical and therapeutic roles, pharmacy staff and individuals working in patient and client care services.
Key findings
The study identifies six central pressures driving low morale and threatening service delivery:
- Severe understaffing and escalating workload pressures: Almost half of respondents reported feeling burnt out “often” or “always.” Workers attributed these pressures largely to inadequate staffing levels and the 2024 ‘Pay and Numbers’ strategy. The report calls for workforce planning based on local needs rather than arbitrary staffing caps.
- Disconnect between senior management and frontline realities: Participants described a top-heavy system characterised by one-way, top-down communication that leaves workers feeling unheard and undervalued.
- ‘Vicious circle’ of low morale and poor retention: The risk of losing staff remains high, reflected in the high number (67%) of those actively considering leaving their role, while the loss of experienced staff increases pressure on those who remain, placing patient care and service stability at risk.
- Direct negative impacts on service quality: Understaffing is leading to longer waiting lists, reduced access to local services, and an increased reliance on private providers. Workers reported that these delays undermine preventative care, worsen outcomes, and demoralise staff who feel they are delivering care far below acceptable standards.
- Clear risks to the delivery of Sláintecare: Workers strongly believe (78%) that staffing levels are far below what is required to deliver the promised shift to universal, community-based care. More than half said they did not feel supported or confident in delivering the changes demanded.
- Urgent lessons for decision-makers: The report calls for evidence-based staffing levels, improved retention strategies, continued progress on pay equity in the voluntary sector, and a stronger worker voice to ensure policy is informed by frontline experience.
Looking ahead
The report highlights the need for evidence-based staffing, stronger retention measures, fair pay, and more meaningful engagement with workers to improve morale, accountability, and the sustainability of health and social care services.
