The HSE is not recruiting any further physician associates/assistants (PAs) pending the conclusion of an independent review of the role, a spokesperson has informed the Medical Independent (MI).
The HSE National Service Plan 2025 stated that “an independent expert” would carry out an assessment of the PA role internationally. The expert would make recommendations for standardisation, scope of practice, and appropriate deployment in Ireland, and would report within six months. The HSE stated on 22 January that this review had not yet commenced.
As reported by MI in August 2024, the Department of Health was reviewing an application from the HSE to formally recognise the grade. However, medical representative bodies have expressed concerns about the parameters of the role. For example, both the IMO and the IHCA have informed the HSE that the PA role must not be used for undifferentiated care and PAs should not make independent decisions about patient treatment. Both organisations also believe the job title should be ‘physician assistant’.
In December, the Medical Council stated it would not be the appropriate regulatory body for PAs. “The Medical Council is aware that PAs are being trained and employed in the Irish healthcare system, working under the supervision of doctors to support the provision of healthcare, contribute to patient management, and improve healthcare access. [The Council] considers it essential that these PA roles are defined with respect to their scope of practice.”
In response, the RCSI stated it had long advocated for a PA regulator. The College described its two-year MSc PA programme as “rigorous” and said entrants required a level 8 health science/science degree. A PA was not a replacement for a doctor and worked under the direction of their supervising consultant. The role helped to enhance healthcare access amid rising patient needs, it maintained.
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