“In Ireland, we’ve added life to years and years to life”

Hilary Coates, Bank of Ireland’s head of health, has an in-depth understanding of the health sector, where she has worked for over 35 years.

Hilary joined Bank of Ireland as head of health and life sciences in 2014 and has supported healthcare providers to grow and scale their businesses. She held previous roles as head of healthcare regulation in HIQA, patient safety advisor at World Health Organization, lecturer in leadership and quality at the Royal College of Surgeons in Ireland and head of healthcare business at Allianz Ireland.

Her extensive senior clinical and business experience gives her a unique understanding of clinical, regulatory and financial aspects of healthcare. Here she discusses the Irish health sector and how it differs from other business sectors in Ireland.

How is the health sector different to other business sectors?

The health sector is unique and it doesn’t operate like other business sectors as at its core it is in the business of providing care. It’s very diverse and ranges from acute care services, primary care services and residential care services to providing care in the home. In all areas there are clinicians whose focus and primary training is caring for patients but who need to keep an eye to business side.

In Ireland, the majority of health services are funded by the State with €16,050m in funding provided by the State to the HSE for the provision of health and social care services in 2019; an increase of 5.6pc (€848m) from 2018. In the nursing home sector, 80% of nursing home care is provided by the private sector with the other 20% by the State. At the moment there are 578 nursing homes with 30,757 beds in Ireland and of those, 122 nursing homes are public and have 6,015 beds.

“People are working to a later point in life, enjoying life more and living longer and we don’t champion that enough.”

What are the successes in the health sector?

Our ageing population is the greatest success story because it means as a country we achieved what we set out to do twenty years ago. We’ve added life to years and years to life. By 2030, there will be an increase of 130,000 people aged 80 and over.

Is that success story celebrated enough?

I always start any presentation by saying this is a huge success story. The life expectancy in Ireland is increasing faster than any other country in the EU. The life expectancy in the EU is 80.6 years, whereas in Ireland it is 81.6 years. That number is up from 1994 when the life expectancy was 75.8 years, which is a significant increase. People are working to a later point in life, enjoying life more and living longer and we don’t champion that enough.

But as people age, there’s a greater demand on the health service with the Department of Health projecting demographic changes will increase health costs by between 1.4pc and 1.6pc annually. In order to understand the requirements for the nursing home sector, Bank of Ireland did a review of the future demand and supply of nursing home beds. We analysed and projected future nursing home bed demand on a county by county basis up to 2026 – drawing from each county’s unique demographic profile, existing beds, those in planning, under construction and those that may be decommissioned.  We analysed the needs for beds on a county by county basis until 2026 and this was done through each county’s demographic profile. This review projects a shortfall up to 7,500 nursing home beds by 2026. By sharing this information with our customers,  we can best support the success of businesses in providing sustainable long term care.

“We recognise the strategic imperative to continue to support investment in the long-term care sector for the country’s ageing population enabling both our customers and communities to thrive.”

How is the sector’s performance based?

There are no homogenous performance indicators for the sector because each area is so different, however, the quality of care provided is always measured. If you take the nursing home sector as an example, the most important thing is the quality of care that is provided to residents and the governance and oversight of this care.


The biggest challenge across the sector is the recruitment and retention of staff. As the economy improves, the sustained decrease in unemployment rates continues to add pressure for recruitment in the health sector particularly in the long-term care sector. This is not just an issue in Ireland though, this is happening all around the world and there’s a shortage of doctors, nurses and healthcare providers globally.

Innovation in the industry

There is an exponential increase in the pace and scale with which digital health care innovations are emerging. Digital technologies are supporting health systems’ efforts to transition to new models of patient-centered care and helping them develop smart health approaches to increase access and affordability, improve quality, and lower costs. These technologies are helping with diagnosis and treatment, helping with speed, quality and accuracy, and improving the patient experience.

For pharmacies just say, it’s either consolidate or to grow by looking at new innovative ways to operate. We’re now seeing robotics in action during the dispensing and packaging of drugs and in other countries, like Japan, we are reading about the about the government funding of artificial intelligence in healthcare. Shintomi Nursing Home in the heart of Tokyo is making international headlines for being home to 20 models of care robots, mimicking cute furry animals, small children, human shaped “humanoids” or full-sized lifting and walking robots. So maybe this will be the future in Ireland!