HSE Ultrasound Scandal: Third-Party Staff Conducting Scans Without Required Qualifications
Investigations have revealed that third-party staff providing ultrasound services to the Health Service Executive are operating without the contractually required postgraduate qualifications, with private provider Affidea Ireland confirming that not all of its sonographers hold the master's-level training stipulated in their HSE contract — a disclosure that has raised serious questions about patient safety and the oversight of private providers contracted to deliver public health services.
Background
The HSE has been contracting private providers to deliver community ultrasound services as part of its effort to reduce waiting lists for diagnostic imaging across Ireland. The use of private providers to supplement public capacity is a well-established practice within the health service, but it comes with significant governance challenges — particularly around ensuring that the staff employed by private contractors meet the same standards as those employed directly by the HSE.
The HSE's contract for community ultrasound services explicitly requires that individuals conducting scans hold a recognised postgraduate qualification in ultrasound at National Framework of Qualifications level nine — the equivalent of a master's degree. This requirement reflects the clinical complexity of ultrasound imaging, which requires not only technical skill but also the ability to interpret findings and identify abnormalities that may require further investigation.
Affidea Ireland, one of the private providers contracted by the HSE, has confirmed that not all of its sonographers hold a master's degree, despite the company asserting that its staff possess appropriate skills and experience. Some staff at Affidea clinics are reported to lack academic ultrasound training entirely, which stands in direct conflict with the HSE's contractual requirements.
Key Developments
The Irish Times and the Irish Medical Times reported on the issue in late July 2026, prompting immediate concern from patient advocacy groups and healthcare professionals. Affidea Ireland has defended its hiring practices, arguing that all of its sonographers are registered with CORU, the health and social care regulator, and are required to have a minimum of six years of exclusive ultrasound practice experience. The company has also noted that all scans are reviewed and signed off by a consultant radiologist, which it argues ensures clinical governance and patient safety.
The HSE has stated that providers are responsible for ensuring their staff meet contractual qualification requirements and that it takes compliance concerns seriously. However, the disclosure raises questions about the adequacy of the HSE's monitoring and enforcement of its contracts with private providers, and about the mechanisms in place to identify and address non-compliance before it becomes a patient safety issue.
The issue highlights a distinction between HSE-employed sonographers, who are subject to the master's degree requirement, and third-party contractors, where such requirements have been inconsistently applied or enforced. Earlier in 2026, reports also surfaced regarding hospitals hiring diagnostic staff without qualifications recognised by the HSE.
Why It Matters
Ultrasound is a diagnostic tool that is used across a wide range of clinical settings, from obstetrics and gynaecology to cardiology, oncology, and musculoskeletal medicine. The quality of an ultrasound examination depends critically on the skill and training of the person performing it, and a scan conducted by an inadequately trained sonographer may miss significant findings or produce misleading results. The consequences of a missed diagnosis can be severe, and the HSE's contractual requirement for postgraduate qualifications is a recognition of this clinical reality.
The disclosure that some private providers are not meeting this requirement is a serious patient safety concern, and it raises broader questions about the governance of the HSE's relationships with private contractors. The health service has been under sustained pressure to reduce waiting lists, and the temptation to prioritise throughput over quality is a real risk in any system that relies heavily on private providers.
Local Impact
For patients who have received ultrasound scans from Affidea Ireland or other private providers contracted by the HSE, the disclosure is a source of understandable anxiety. The HSE has not indicated whether it intends to review the scans conducted by staff who did not hold the required qualifications, and patient advocacy groups have called for a full audit of the private provider contracts and the qualifications of the staff employed under them. The Irish Medical Organisation has called for urgent action to ensure that all patients receiving HSE-funded services, regardless of whether they are delivered by public or private providers, receive care from appropriately qualified staff.
What's Next
The HSE is expected to conduct a review of its contracts with private ultrasound providers and to assess the qualifications of the staff employed under those contracts. The Department of Health has been briefed on the issue and is monitoring the HSE's response. CORU, the health and social care regulator, is also expected to review its registration requirements for sonographers in light of the disclosure. The Oireachtas Health Committee is likely to seek a briefing from the HSE on the matter when it returns from recess in September.
