Skip to main content

Annual Report 2020 now available

The HSE has published its Annual Report and Annual Financial Statements for 2020, a year like no other.

Published: 1 July 2021

As a population and as a health service, we faced significant challenges but also demonstrated how we can pull together, innovating and adapting our practices. Our challenge now is to learn from this collective experience and to build the positive elements into our way of working, confident that we will emerge from the pandemic with a stronger, more united and more integrated health system.

HSE Annual Report and Financial Statements 2020

COVID-19 Impact and HSE Response

COVID-19 is the most serious global pandemic in over a century. Its impact was felt in all aspects of our lives and by the end December 2020, there were nearly 92,000 positive cases and more than 2,200 deaths in Ireland. In dealing with COVID-19, a national unity of purpose was demonstrated in the manner that the population as a whole embraced and complied with public health advice and guidance. Our fight against COVID-19 required the HSE to maintain a balance between careful, considered planning and rapid decision-making, led by public health in line with data, evidence and best practice as it emerged. The pandemic necessitated a range of new services and new ways of working to be introduced at pace to respond to the health needs of the population and to protect staff.

  • Elective and non-essential services were restricted and staff were redeployed from all areas of the health service
  • Key technology initiatives were developed to enable and support the COVID-19 model of care including development of the COVID-19 mobile tracker app with 1.3 million (m) users
  • COVID-19 Response Teams were established to support public health outbreak teams covering residential services and home support settings
  • A sustainable and flexible National Testing and Tracing Operating Model was developed with a laboratory capacity of 25,000 tests per day and 440,000 contact tracing calls completed in 2020
  • Expenditure on personal protective equipment (PPE) increased to over €900m.

The end of 2020 brought new hope with the approval of a vaccine against COVID-19. By end December 40,950 vaccine doses had been received into Ireland with the first vaccine administered on 29 December. The HSE continues to work in partnership with the Government’s High-Level Task Force on COVID-19, the Department of Health and other stakeholders in the delivery of the national COVID-19 Vaccination Programme, taking the lead role in its operational roll-out.


The HSE had a total expenditure of €20.064 billion in 2020, including funding to non-statutory agencies of €5.442bn. The total capital expenditure was €984 million  including capital grants to voluntary agencies of €360m.

Human Resources

The HSE recognises the vital role of our staff at all levels of our organisation in addressing the many challenges in delivering health and personal social services. Since 2019, overall staffing levels have increased by 5.3% (or 6,357 WTEs). The largest growth was seen in nursing and midwifery (+1,712 WTEs) followed by patient and client care (+1,266 WTEs). Health and social care professionals was the third highest staff category showing an increase, with an additional 1,033 WTEs.

Supporting Service Delivery

An estimated 4.98m people live in Ireland (Central Statistics Office), with a population increase of 55,900 people from April 2019 to April 2020.This, along with the 64,500 increase seen in 2018 / 2019, represents the largest increase since 2008. The population is growing across all regions and age groups, with the most significant growth seen in the older age groups. Despite the necessary focus on responding to the COVID-19 pandemic, work continued to ensure a balance between responding to illness and enabling good health and disease prevention.

Life expectancy in Ireland has increased by 2.5 years for men and by 2 years for women since 2008 with women now living to, on average, 84.1 years and men 80.5 years. The greatest gains in life expectancy have been achieved in the older age groups reflecting decreasing mortality rates from major diseases.

The three most common chronic diseases in Ireland are cancer, cardiovascular disease and respiratory disease and these give rise to three quarters of deaths in Ireland. Approximately 32% of those over 18 years of age currently have one or more chronic diseases.

During 2020:

Community Healthcare

  • Almost 1.6 million people were covered by a medical card.
  • Almost 530,000 people were in receipt of a GP visit card.
  • 91.6% of children had received their measles, mumps, rubella (MMR) vaccine at 24 months.
  • Over 17.5 million home support hours were delivered to almost 53,000 people (excluding hours from intensive home care packages).
  • 75 people completed the transition from congregated to community settings
  • Over 21,000 day respite sessions were provided for people with disabilities.
  • Almost 24,000 adults were seen by General Adult Mental Health teams.
  • Over 3,200 patients accessed a specialist inpatient palliative care bed with an equivalent number receiving specialist palliative care treatment in a home setting.

Acute Services

  • Almost 1.5m people received inpatient or day case treatment, with over 900k of these on a day case basis.
  • Almost 3m people attended outpatient departments.
  • There were over 1.2m emergency attendances.
  • 76.9% of adults waited less than 15 months for a planned inpatient procedure and 85.4% for a planned day case procedure.
  • 79.6% of children waited less than 15 months for a planned inpatient procedure and 81.4% for a planned day case procedure.
  • 57.8% of patients waited less than 52 weeks for an outpatient appointment.