Why this sector matters
Healthcare procurement sits among the most complex and high-stakes domains in the public sector. Clinical risk is tangible, technologies evolve quickly, and total lifetime costs can far exceed initial purchase prices.
Within the Health Service Executive (HSE), third-party goods and services account for billions annually, meaning that how the system buys directly shapes patient access, outcomes and budgets. The HSE’s Corporate Procurement Plan estimated spend on goods and services at approximately €3.7 billion within a €21 billion overall budget for 2022, highlighting both the scale and leverage of health procurement decisions.
With such a large spend procurement in the HSE naturally comes under review on a regular basis. However, HealthTech Ireland’s 2021 review of procurement practices in the Irish health system remains one of the most authoritative reference points for understanding ongoing challenges. We set out below some of its recommendations to help strengthen the sector, together with recommendations from other bodies that it has helped to inspire.
What the IMSTA (HealthTech Ireland) review said
The review identified an over-reliance on tactical, price-driven purchasing, where decisions place disproportionate weight on unit cost. This approach can overlook broader factors such as clinical performance, patient outcomes, long-term value, and the overall impact on care pathways.
It also highlighted limited adoption of lifecycle thinking. HealthTech Ireland explicitly recommended that Total Cost of Ownership (TCO) should become a standard award criterion. TCO ensures that purchasing decisions account not only for acquisition price but also for ongoing costs of consumables, maintenance, training, productivity impacts, downtime, and end-of-life replacement or disposal.
Another key recommendation concerned structured supplier engagement. The review noted that early dialogue, market sounding, and pre-procurement collaboration are still underused across the health sector. This limits awareness of emerging innovations, makes it harder to assess interoperability challenges in advance, and increases the risk of selecting solutions that later prove difficult to deliver or integrate.
A complementary HealthTech Ireland report on digital health procurement reached similar conclusions. While the MEAT (Most Economically Advantageous Tender) framework is in place, procurement practice often defaults to transactional evaluation. HealthTech Ireland urged that value-based procurement, measuring outcomes in terms of patient results, system-level efficiency, and total pathway costs, be more widely embedded across the health system.
Policy and regulatory context in Ireland
HSE procurement architecture: HSE Procurement coordinates national purchasing and collaborates with the Office of Government Procurement (OGP) on shared frameworks, focusing on compliant contracts and controlled spend.
Pre-market engagement: Irish guidance explicitly allows Preliminary Market Consultations (PMCs) before tendering. The OGP updated its public guidance in 2024 to clarify how buyers can lawfully and transparently engage with suppliers and experts to understand market capabilities.
Guidelines framework: The OGP’s Public Procurement Guidelines for Goods and Services reiterate that market consultation is lawful under the European Union (Award of Public Authority Contracts) Regulations 2016, provided it informs specifications and strategy while maintaining fairness and competition.
Green procurement and lifecycle costing: The HSE’s Green Procurement Strategic Framework encourages the use of Life-Cycle Costing (LCC) wherever post-purchase costs are material, helping to normalise TCO methods across health frameworks.
Regulatory compliance (EU MDR): All buying decisions must align with the EU Medical Device Regulation (MDR) 2017/745, including requirements for Unique Device Identification (UDI) traceability and clinical evidence. The European Commission continues to update guidance and transitional provisions (2020–2025) affecting both legacy and new devices on the market.
What “strategic” health procurement looks like for Ireland
Building on HealthTech Ireland’s recommendations and existing HSE/OGP guidance, Irish contracting authorities can strengthen health-sector procurement by embedding the following principles:
- Integrate life-cycle costing: Apply LCC wherever post-purchase costs are significant, and link these results directly to MEAT scoring, as already expected under the HSE’s Green Procurement Framework.
- Normalise PMCs: Make Preliminary Market Consultations routine for complex or innovative categories. Structured PMCs help refine specifications, identify supply and interoperability risks, and clarify data requirements (e.g. UDI and cybersecurity) while ensuring transparency and compliance.
- Focus on outcomes: Move beyond technical and price scoring. Include award criteria linked to clinical outcomes, workforce efficiency, and total cost of care, reflecting HealthTech Ireland’s value-based procurement principles.
- Develop supplier relationships: Extend engagement beyond contract award. Category strategies should include performance reviews, shared data, and continuous improvement to reduce delivery risk and enhance long-term value.
- Embed compliance and data standards: Address MDR, UDI traceability, and cybersecurity requirements directly within specifications and evaluation criteria.
- Align with sustainability goals: Assess carbon, waste, and circularity alongside clinical and financial considerations using proportionate life-cycle methods.
Actionable checklist for Irish health buyers
Can be used by buyers to maximise the effectiveness of healthcare and medical device procurement. The following actions help ensure value for money, compliance, and better patient outcomes across the full procurement cycle, from planning and market engagement to contract management and performance reporting.
- Plan a PMC for your next complex device category and publish a transparent note of what you learned.
- Add a TCO/LCC model to your award design, with verifiable inputs for service, consumables, training and disposal.
- Include outcome and pathway KPIs in award and contract management, not just technical compliance.
- Build MDR, UDI and data-security obligations into the specification and contract conditions from the start.
- Use HSE systems for contract visibility and supplier performance, and report benefits at pathway level.
Sources:
NHS to invest in pioneering tech to drive down waiting lists https://www.gov.uk/government/news/nhs-to-invest-in-pioneering-tech-to-drive-down-waiting-lists
Procurement Compliance Improvement https://www.ehealthireland.ie/news-media/news/2025/procurement-compliance-improvement
PUBLIC PROCUREMENT GUIDELINES FOR GOODS AND SERVICES https://southernassembly.ie/wp-content/uploads/2025/02/OGP_Version_2_OGP_Guidelines_Goods_and_Services_012019.pdf
A Review of Current Procurement Practices in Ireland – Dr Paul Davis https://www.healthtechireland.ie/wp-content/uploads/2021/03/IMSTA-Procurement-Report-FINAL-version.pdf
