Agency Staff or Permanent Overseas Hires? What Irish Nursing Homes Actually Pay for Each, and When a Work Permit Hire Pays Back

The Short Answer

Agency cover costs nothing up front and a lot by the hour. A permanent overseas healthcare assistant costs a one-off sum and a wait of months, then costs base pay. The permanent hire pays back once the hourly gap between your agency invoice and your own payroll cost has covered the one-off spend.

So the useful question for a nursing home is how many agency hours this person will replace, and how soon. A home booking agency HCAs every week to fill a rota hole will usually find the permanent route wins. A home that books agency for sick days and the odd short-notice gap may not.

The sums here are for healthcare assistants on a General Employment Permit. Nurses follow a different route, with NMBI registration first; our guide to hiring nurses from overseas covers it.

The Agency Side of the Sum

In a June 2026 reply to a parliamentary question, the Health Service Executive put agency staff costs for its own services at €726 million in 2024. The draft figure for 2025 was €832 million. In 2024 it also approved 960 whole-time equivalent posts for converting agency staff to direct employment. The State has run the same sum you are about to run, and part of its answer was to put agency staff on its own payroll.

For your own home, start with your agency invoices, because that is where your rate is written down. Pull three months of them and note two things:

• The hourly rate you pay per HCA shift, including any weekend, night or short-notice premium.
• How many agency hours you book in a typical week for the role you are thinking of filling permanently.

If your agency charges more for nights, weekends or late bookings, use what you actually paid rather than the headline rate.

The Permanent Side of the Sum

A permanent HCA on a General Employment Permit has an ongoing cost and a one-off cost.

The ongoing cost is pay. DETE's minimum for a Health Care Assistant is €16.12 an hour: €32,691 a year on a 39-hour week, or €33,529.60 on a 40-hour week. That figure is basic pay only. Guaranteed premium payments can count towards it. Bonuses, shift allowances and overtime cannot. Add what else each of your own employees costs you on top of pay, so you compare like with like against the agency rate.

The one-off costs are recruitment. The fixed items are:

• The DETE permit fee. €1,000 for a General Employment Permit of up to 24 months.
• The Labour Market Needs Test. The vacancy must run on JobsIreland for 28 days in a row, with no changes to the advert, before you can apply.
• Your recruitment fee, if you use an agency to source and manage the hire.

Then there are the costs you choose, such as help with a flight or the first few weeks of accommodation to make the offer stand out. Those are your decision, and our full cost guide for overseas hires sets out which costs fall on the employer and which do not.

One rule shapes this side of the sum. Section 55 of the Employment Permits Act 2024 covers the permit application, the worker's recruitment, and travel expenses you paid them. You cannot deduct any of those costs from a permit holder's pay, or recover them from the worker in any other way. The one-off costs are yours to carry, and no repayment clause in a contract changes that.

Working Out Your Break-Even

The sum takes four steps:

1. Add up your one-off costs: the DETE fee, the recruitment fee and anything you choose to fund, such as a flight.
2. Find the hourly gap: your agency invoice rate for an HCA shift, minus the hourly cost of the same hours on your own payroll.
3. Multiply the gap by the agency hours the permanent hire will replace each week. That is your weekly saving.
4. Divide the one-off costs by the weekly saving. That is how many working weeks the hire takes to pay back.

Here is a worked example. The numbers are chosen only to show the method. Say the gap is €5 an hour, and the new hire replaces a full 39-hour week of agency shifts. The weekly saving is €195. On those assumptions, every €1,000 of one-off cost is earned back in a little over five weeks of shifts. Run it with your real invoice rate. A bigger gap pays back faster, and a hire who replaces only part of your agency hours pays back slower.

Two things the sum leaves out cut in the permanent hire's favour. A permanent HCA learns your residents, your care plans and your routines, which is hard for agency staff who change from week to week. And a rota built on your own staff is one you control, rather than one that depends on an agency filling a Saturday night.

The Months You Still Need Agency Cover

The break-even clock does not start on the day you decide. It starts on the day the new HCA works their first shift.

Before that day, the vacancy has to run on JobsIreland for 28 days, DETE has to process the application, and the worker then has to travel. Your agency spend carries on through all of it, so put it in the budget from the start. Ask us for a current estimate for your role before you plan around a start date.

Two permit rules can stretch the wait or stop it:

• The care worker quota. Care workers and home carers sit inside a quota of 1,495 General Employment Permits, set by S.I. 213 of 2026 from 13 May 2026. Check how much of it is left before you advertise.
• The 50:50 rule. At the date you apply, at least half your employees must be nationals of the EEA (the EU countries plus Iceland, Liechtenstein and Norway), Switzerland or the UK, counted across the whole workforce. A home already heavy on permit holders can hit this before it hits the quota. A change for health and social care has been proposed but is not law yet; our post on the 50:50 rule and care employers tracks where it stands.

What a Permanent Hire Can Still Cost You

A permit holder can move after nine months. The Employment Permits Act 2024 lets a General Employment Permit holder change employer, within the same occupation. They can do it once nine months have passed since they started their first permit job in the State. Before that, they are expected to stay with the employer on the permit. A worker who leaves at month ten has still covered most of a year of shifts, but your break-even needs to land well inside that window to be safe. Fair pay, decent rosters and help settling in are what keep people past it. Our guide to when a permit holder can change employer covers the rules in full.

The qualification bar rises at renewal. DETE's checklist says a Health Care Assistant applying to renew a permit should have a relevant QQI Level 5 qualification after two years of employment in the State. Plan the training early, or the renewal is at risk.

Agency cover does not disappear. Sick leave and holidays still need covering, and so does the shift someone drops at short notice. The aim is to move your regular, predictable hours onto your own payroll and keep agency for the hours nobody can predict.

How CA Recruitment Helps

If agency HCAs are a fixed line on your monthly costs, send us your invoice rate and weekly hours. We will work out the break-even for your home and tell you plainly whether the permanent route makes sense. See our page on hiring overseas care workers, or book a free consultation.

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