The role of healthcare assistant is ill-defined and poorly paid despite its increasing importance to the healthcare system, according to new research by independent think-tank Tasc.
Clarity is required on the qualifications required to do the job, according to new research published by the independent think-tank, it added.
In a wide-ranging review of existing literature, Dr Adeelia Goffe and Dr Brona Farrelly conclude the healthcare assistant role “lacks a clear national definition and standardised tasks, causing confusion and overlap with nursing duties”.
“Regulation is inconsistent, with no unified registration or mandatory qualifications, leading to wide variation in pay, qualifications, and conditions,” the report added.
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These variations, they find, are especially marked when comparing public and private employment settings.
The report finds that healthcare assistants are commonly also known as, among other things, carers, care support workers or care assistants. This vagueness of title makes even establishing the number employed across the health system difficult.
While the HSE put the number it employed at 20,272 in 2024, up 15 per cent in one year, reliable figures from the private sector are not available, with estimates varying substantially.
Pay and conditions, they find, are generally better in the public sector, with average earnings put at more than 10 per cent higher in hospitals when compared to nursing homes or homecare settings.
The report cites research commissioned by the Department of Enterprise and Employment for 2024 that suggests Irish or EU healthcare assistants working in nursing homes could expect to earn €31,333 per year, while in a hospital the average yearly salary was €35,916, and in home care it was €32,245.
The proportion of workers in the private sector who have come from outside the EU is much higher and so earnings there, it is suggested, are driven to a significant extent by the requirements of the employment permit system.
The qualifications required to get a job as a healthcare assistant is usually set at QQI level 5 but the report finds a lack of regulation or clarity around this.
It finds that the sector is populated by a workers with Irish qualifications of different levels, overseas workers with different qualifications, a significant number with informal, “on the job” training and others with no qualifications at all.
Although there are many courses here, they vary in structure, content and cost, with fees ranging from nothing to more than €2,000.
The authors suggest policymakers should move to provide a clear definition of the role, establish a system of professional registration and set clear educational standards.
“Amid growing care demands from an ageing population, strengthening regulation, education, career development, and professional support for [healthcare assistants] is essential to improve workforce stability, care quality, and the sustainability of healthcare services across Ireland,” they say.
