HSE owed €60 million by patients who left hospital without paying bills
Darragh Mc Donagh
The Health Service Executive (HSE) was owed just under €60 million at the beginning of last year by patients who failed to pay their bills after being discharged from hospital, new figures have revealed.
Another €138.4 million was owed by private health insurance companies in respect of charges for procedures that were carried out in public hospitals.
The figures also show that more than €16.6 million in respect of unpaid patient fees was written off by hospitals as bad debts during the preceding two years despite spending €500,000 on debt collection agencies in 2024.
Of the €59.8 million owed to public hospitals at the start of 2025, more than €23.8 million related to inpatient charges – all of which were incurred prior to April 2023, when the levy was abolished.
Patients who were treated at hospital emergency departments and left without paying the €100 fee accounted for just over €14.5 million of the monies owed to the HSE, according to records released under freedom of information laws.
Almost €21.2 million related to unpaid charges arising from road traffic accidents, while €268,729 was still owed to Bantry General Hospital in respect of long-stay charges, which were abolished in 2017.
University Hospital Galway (UHG) alone accounted for more than 20% of the total outstanding debt, recording the highest amount owed in respect of every type of patient charge.
A spokesperson for the hospital said it was undertaking an ongoing review of aged debtor accounts and account closures as it proactively manages and reviews outstanding debt.
UHG was owed €2.4 million in inpatient charges at the beginning of last year. The next-highest amount was €544,737 recorded by Midland Regional Hospital in Portlaoise, followed by €444,153 at Sligo University Hospital.
More than €3 million was still owed to UHG in respect of unpaid emergency department charges, while €1.7 million was owed to Midland Hospital in Portlaoise, and €998,587 was owed to Our Lady of Lourdes Hospital in Drogheda.
Some €6.5 million or around 30% of the €21.2 million in unpaid patient charges relating to road traffic accidents was owed to UHG, while Cork University Hospital (CUH) was owed €3.2 million under this category.
A spokesperson for UHG said the debt balance included a number of “high-value claims” pertaining to road traffic accidents. “These cases typically take a number of years to process and resolve due to their complexity,” they added.
The hospital was also owed €28.7 million by private insurers at the start of last year. This was the highest in the country, followed by CUH with €16.9 million and Our Lady of Lourdes Hospital with €15.7 million.
Figures for a number of public hospitals were lost when data was migrated to a new accounting system in 2024 and could not be provided by the HSE.
A spokesperson for the executive said it had a statutory responsibility to pursue unpaid debts in a “structured and proportionate manner”, including by referring outstanding fees to external debt collection agencies after a certain period where appropriate.
“If a patient experiences difficulty in paying a hospital bill, the regulations allow for the hospital and the patient to agree an instalment arrangement. Patients are advised to contact the HSE directly, on a one-to-one basis, to discuss their individual circumstances,” they added.
“The HSE seeks to maximise the recovery of income in a socially responsible, ethical, efficient and cost-effective way. It should be noted that the collection of monies owed is a continuous, daily and large-scale process.”
They said any decision to write off patient debt is taken by individual hospitals with regard to the type of charge, value of the debt, the patient’s circumstances, the length of time the debt is outstanding, and the cost of recovery.
