Private-private pay gap widening in healthcare, says survey

Private healthcare providers struggling with wage bills and staffing

Private healthcare providers in Ireland are stuggling to cope with rising wage bills and staffing shortages, according to a salary guide for the sector released today.

Private healthcare providers in Ireland are stuggling to cope with rising wage bills and staffing shortages, according to a salary guide for the sector released today.

The 2026 Excel Healthcare Salary Guide says that costs for private providers are increasing by up to 10% due to the new minimum wage of €14.15, while vacancy rates for nurses and healthcare assistants remain high despite the lifting of the HSE recruitment freeze.

"The public-private pay gap has widened to between 15% to 20% for many frontline roles, which is making it even harder for private employers to compete," said Excel Healthcare director Martina Young.

“We are seeing strong demand right across nursing, allied health and support services, but providers are struggling to match candidates’ expectations around pay, flexibility and workload."

The healthcare guide states that salaries across the sector have risen with average pay for nurses now between €44,000 and €48,000 depending on experience, while healthcare assistants are earning between €33,000 and €36,000.

Senior healthcare assistant upper level pay in 2026 is expected to be €20 per hour, from €17.50 hourly in 2025 (+14.3%).

“These increases are improving retention, but they are also putting pressure on smaller independent providers already dealing with rising operational costs," said Ms Young.

Director of nursing roles are now expected to average at €98,000 going into 2026, €3,000 higher than in 2025 (+3.1%).

Excel Healthcare said burnout, living costs and the challenges of attracting and retaining international staff are some of the biggest pressures on the industry, with nursing homes and long-term care providers facing particular pressures.

 “Several smaller homes have closed in recent years due to the Fair Deal Scheme’s failure to keep pace with inflation. Larger groups are absorbing some of the demand, but capacity remains short," said Ms Young. 

"The ESRI has projected a requirement for 60% more long-term care beds and home support hours by 2040. Both Nursing Homes Ireland and The Alliance (a trade association supporting members in the nursing home sector) are calling for a modernised cost-of-care model and between €160m and €170m in additional annual funding. Without that, operators will continue to struggle to keep services sustainable.”

Last month, in its State of the Register 2025 report, the Nursing and Midwifery Board of Ireland said there were 92,385 nurses and midwives on the NMBI Register, which represents a 3% increase on the previous year. It is the largest number of registered nurses and midwives recorded to date.

The number of practising and patient facing registrants also increased, according to the report, with 86,948 nurses and midwives state that they are currently practising (a 3% increase) and 79,194 state they are patient-facing (a 4% increase).

According to the Excel Healthcare survey, work-life balance is now a major factor in career choice, with more staff moving to step-down, community, and home care roles. It said recruitment and retention are increasingly difficult due to the 50:50 non-EU staffing rule, visa challenges and housing shortages. 

“Candidates are looking for manageable workloads, predictable rosters and supportive environments. Pay matters, but it is clear that work-life balance and organisational culture are now just as important,” said Ms Young.