For years, Sláintecare has been the health reform everyone talked about and few people could point to. This year that changes. Look at the figures coming out of the Department of Health and a different story emerges: hospitals are cheaper to use for more people, new operating theatres are opening one after another, and for once the state can actually count how many of its promises it has kept.
What Sláintecare actually is, and where it stands now
Sláintecare is Ireland's ten-year, cross-party plan to build a universal, single-tier health service where care depends on need, not the ability to pay. It runs until 2028, and this year marks a shift in how it's delivered: the old multi-year implementation reports have given way to an annual cycle, with the Sláintecare Progress Report 2025 published alongside the Sláintecare Action Plan 2026 (SCAP26), which the Department says is currently being rolled out.
Officials are already looking past that deadline. The Department has confirmed that 'initial steps' are being taken to plan a successor reform programme for after 2028, built on what has worked so far, according to the Medical Independent, which reported in June 2026 that the focus will stay on access, integrated care through the new HSE health regions, and value for money as demand keeps climbing.
SCAP26 itself is built around four priorities: Improve Access, Improve Service Quality, Build Capacity and Enabling Reforms, each with its own named deliverables for the year, according to the published plan. That structure matters, because it gives anyone checking the Department's homework a concrete list of promises rather than a vague direction of travel.
That continuity is the real signal here: Sláintecare is being treated as a long-term direction rather than a plan quietly shelved. The Progress Report 2025 calls itself 'a pivotal moment' in the journey towards universal healthcare, and for once that framing is backed by real numbers.
Hospital charges: more free care for more people
One of Sláintecare's founding principles is simple: people shouldn't pay just because they turned up sick. The Progress Report 2025 shows real movement here, with the Minister for Health's foreword stating that 43% of people are now accessing health services without charge, a shift the Department credits directly to Sláintecare's affordability agenda.
That builds on eligibility work already under way. The 2024 progress report recorded that up to 50% of the population can now access either a free GP visit card or a medical card, a landmark in a country where GP fees have historically kept people away from early treatment. Continuing that expansion, alongside reviewing hospital charges, remains a named priority in the 2025 report's 'Eligibility and Affordability' section.
Widening that eligibility further is a work in progress rather than a finished job. Responding to a Dáil question in June 2026, the Minister for Health confirmed the Department, the ESRI and the Irish Government Economic and Evaluation Service have been analysing the cost of expanding GP visit card and medical card access, while acknowledging a full costing for universal primary care isn't yet possible because it would require changes to GP contracts and workforce capacity. Affordability gains, in other words, are being built step by step, not delivered in one go.
Not every affordability question has moved as fast. Deputy Pádraig Rice told the Dáil in May 2026 that the income thresholds used to assess medical card eligibility for people under 70 haven't been raised in over twenty years, despite inflation and rising welfare payments. The Minister's written response confirmed the thresholds were still under review, but gave no firm date for change, a reminder that some of the harder, means-tested parts of this agenda move more slowly than the headline free-care figures.
None of this is happening against a backdrop of public despair, either: the same report finds 82% of people rate their own health as 'good' or 'very good', and life expectancy stands at 82.9 years, both cited by the Department as signs that the system keeps serving people well while reform continues around them.
New surgical hubs are opening, not just being announced
The most visible, concrete Sláintecare win in 2026 is the surgical hub building programme. These are new, purpose-built units that separate planned day-case surgery from unpredictable emergency work, so a hip scope or a cataract procedure doesn't get bumped because an ambulance has arrived. Nine hubs are being delivered nationally, according to the Minister for Health's answer to the Dáil in July 2026.
Two are already open and treating patients: the Reeves Centre in Tallaght and the Mount Carmel Hub in South Dublin, the latter opened in February 2026 by Minister for Health Jennifer Carroll MacNeill and featuring one of the country's first 'green' operating theatres, according to the HSE. Five more are expected to open this year, in Limerick, Swords, Galway, Cork and Waterford.
The Dublin and North East Surgical Hub in Swords opened in mid-2026 with four operating theatres, two minor procedure rooms, an 11-bay recovery unit and a 21-bay day ward, the HSE said, designed so patients can have a procedure, recover and go home the same day. Each hub in the network is expected to deliver around 10,000 day-case procedures and 18,500 outpatient consultations a year once fully operational, per HSE figures from October 2025.
Behind the hubs, the longer-term Elective Treatment Centres for Galway, Cork and Dublin remain in the pipeline, with the hub network acting as the faster-to-build first phase while those bigger elective hospitals are planned, the Minister confirmed in Dáil answers this year.
The hub model is also becoming the template for how Sláintecare wants public capital spent generally: smaller, faster-to-build units that start treating patients within a couple of years, instead of waiting a decade for one large hospital project. That lowers the risk of any single project slipping, and it means patients in Limerick, Galway, Cork and Waterford should feel the benefit of extra capacity on roughly similar timelines, rather than one region waiting years longer than another.
More staff, more consultants signed up, more primary care
None of this works without people. By December 2024 there were approximately 148,268 staff working in health and social care in Ireland, up almost 24% on 2020 levels, according to the Sláintecare Implementation Progress Report 2024. By then, 2,770 hospital consultants had signed the Public Only Consultant Contract, which the Department says allows better planning of patient flow because it removes private practice from public hospital time.
Community care has expanded too. There are 179 Primary Care Centres now operational, with five more planned, according to the Sláintecare 2025+ framework covering 2025 to 2027. Through the Enhanced Community Care Programme, the target for 2025 was to see over 1.6 million patients through Community Healthcare Networks, shifting more care out of hospitals and closer to home.
None of this means every target has landed on schedule. The Medical Independent has reported some governance gaps, including a lapse in Sláintecare programme board meetings earlier this year. But taken together, more free care, more open hubs, more staff, more community capacity, the 2025 figures are the clearest evidence yet that the plan is moving from paper to practice.
The Enhanced Community Care Programme also underpins the consultant contract reforms, since keeping more low-acuity care in the community is what frees up hospital consultants and beds for the patients who need them most. SCAP26 lists removing private care from public hospitals as its own dedicated action area for 2026, alongside primary care therapies access and waiting list reform, a reminder that workforce reform and community capacity are being tracked as connected parts of the same plan rather than separate projects.
The Bottom Line
Sláintecare won't be finished by its original 2028 deadline in every respect, and officials are already planning what comes after it. But 2026 is the year the numbers finally caught up with the ambition: real hospital charge relief for more households, real operating theatres opening their doors in Tallaght, Dublin and Swords with more on the way, and a workforce and primary care base that has genuinely grown. For patients, that adds up to shorter routes to routine surgery and cheaper access to care than a few years ago, with more of the same promised through 2026 and 2027.
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