HSE paid debt-collection agencies €1.2m to chase patient bills

The Health Service Executive (HSE) in Ireland has paid more than €1.2 million to private debt‑collection agencies over the past three years to pursue patients for unpaid hospital charges.​​

What the €1.2m relates to

• The payments went to at least four private companies contracted to recover outstanding patient bills on behalf of HSE hospitals.​​

• The spending covers a three‑year period and relates specifically to unpaid statutory hospital charges owed by patients.​​

Why the HSE uses debt collectors

• HSE guidance allows hospitals to refer “difficult to collect” patient debts to external debt‑collection agencies once internal reminder and follow‑up processes have failed.​

• Local hospital management decides when to refer cases, in line with national income and debtor procedures, to improve recovery of long‑overdue bills.​

How the process works for patients

• HSE policy sets out a sequence of invoicing, written reminders and phone contact before any referral to a debt‑collection agency is made.​

• Once referred, agencies are generally confined to written contact with patients under the public‑sector debt‑management framework, rather than doorstep visits.​

Criticism and concerns

• Patient advocates and some medical organisations argue that pursuing sick or vulnerable people for charges through private collectors is unfair and adds stress during illness.​

• Similar HSE figures released in previous years showed hundreds of thousands of euro paid annually to debt‑collection firms, prompting recurring debate about the policy’s ethics and value for money.​