By Héloïse Chaudot 
Barry Downes is Chief Executive Officer of Affidea, a role he has held since 2017. Under his leadership, the company has transformed into one of the leading healthcare providers in the UK and Ireland, expanding access to advanced diagnostics, community-based healthcare and specialist services.
What are your main priorities and goals in your role?
My number one priority is to ensure a safe working environment for all staff and colleagues, where people feel supported and able to perform at their best. That foundation of safety is essential in healthcare, and everything else depends on it. Following that, patient satisfaction is central to everything we do. Every interaction, from initial appointment through to treatment and follow-up, should reflect a high-quality, compassionate and efficient patient experience.
Alongside this, we are committed to the continued delivery of world-class clinical care, underpinned by strong clinical governance, investment in modern equipment and access to leading clinicians. As a healthcare business, we also have a responsibility to operate sustainably and deliver a fair return on investment for our shareholders, ensuring the organisation remains strong, resilient and able to continue investing in services, people and innovation over the long term.
What are your biggest challenges as CEO?
The role is inherently multifaceted, with a wide range of stakeholders, each with different expectations. For patients, the focus is on timely access to the best clinicians and equipment. For shareholders, it is about delivering consistent year-on-year growth. At the same time, we must manage rising operational costs in Ireland while ensuring our people remain supported, engaged and motivated. Balancing all of these priorities is a constant challenge.
How do you keep your team/staff motivated?
Healthcare is unique in that most people enter the sector driven by purpose rather than purely professional ambition. Our staff make a real difference every day, often improving the quality of life for patients and providing support. That sense of impact is a powerful motivator.
Additionally, many are energised by being part of a fast-growing organisation, with clear ambitions to double the size of the business every three years.
What are the challenges facing the industry going forward?
Medicolegal costs remain a significant challenge in the healthcare sector in Ireland.
With visibility across multiple markets, we see variations in claim volumes, settlement levels and wider legal costs across different jurisdictions. In Ireland, these costs can be relatively high in certain areas of practice, which adds to overall pressure on healthcare providers and insurers operating in the market.
What new trends are emerging in your industry?
One of the most significant trends in healthcare is the ongoing shift in service delivery from hospitals to community-based settings. This is an area where Affidea has been investing for several years, and where we are continuing to build a strong and sustainable market position.
Alongside this, the increasing use of technology and data-driven tools in patient management and care delivery is transforming how services are delivered, improving access, efficiency and outcomes for patients and providers alike.
Are there any major changes you would like to see in your sector?
Greater alignment and long-term partnership between the public and private sectors would be really beneficial. The private sector has demonstrated its ability to help reduce public waiting lists, particularly in high-volume areas such as diagnostics.
To support this effectively, longer-term contracts with fair, transparent reimbursement mechanisms that reflect inflation and rising employment costs would create a more sustainable framework.
As an employer, are you finding any skill gaps in the market?
Yes, there are ongoing challenges. We continue to see clinical staff trained in Ireland emigrating for a variety of reasons, which creates pressure on the domestic talent pool. In Dublin in particular, the cost of living makes recruitment more difficult for certain roles.
Interestingly, we are also seeing staff choose to relocate from Dublin to our regional clinics, where affordability and quality of life are stronger.
How did your strategy develop in the context of the banking crisis and economic crisis?
Operating across 15 European markets means we regularly face different economic and political challenges. For example, in some Central and Eastern European countries, healthcare funding has been redirected due to geopolitical pressures such as the Russia – Ukraine conflict.
This reinforces the need for adaptability. A key priority in any environment is maintaining a robust strategy that can withstand unexpected and external shocks.
How do you define success, and what drives you to succeed?
Success, for me, is about achievement, regardless of scale. It’s about being able to look back at the end of a day or week and feel you have made progress or delivered something meaningful. That sense of accomplishment is what drives me.
What’s the best advice you’ve been given in business?
One of the best pieces of advice I ever received was to trust your gut – particularly when it comes to people decisions, whether hiring or managing performance.
It came from a former Chairman I worked with, who said that in many situations, you already have an instinct about what the right answer is, but people sometimes overthink it or try to force something that isn’t going to work in the long term.
While it can be difficult at times, it is often better to address issues early rather than prolong situations that are unlikely to improve. That has stayed with me throughout my career and has been particularly relevant in leadership roles where people and performance are so closely linked.
What advice would you give to others starting in business?
Be prepared for a rollercoaster. On a serious note, anyone starting a business in Ireland deserves significant recognition and support. Small and medium-sized enterprises are the backbone of the economy and play a vital role in driving growth and innovation.
What have been your highlights in business over the past year?
Over the past 12 months, we have initiated several major greenfield developments that will significantly transform healthcare delivery in the markets they serve. We have also continued to grow the business and successfully completed our triennial Joint Commission International (JCI) accreditation survey. While always a demanding process, it serves as a strong validation of the world-class care delivered by our teams.
In addition, we launched our Heart Health Check programme in Dublin, which empowers individuals to better understand their cardiovascular risk and take proactive steps to protect their long-term health. The programme will also be introduced in Cork this summer, further expanding access to preventative healthcare services.
We also announced the commencement of construction on a major new 100,000 sq ft healthcare facility on Belfast’s Boucher Road. The facility will provide advanced diagnostic imaging, specialist consultations, outpatient procedures and inpatient surgery, significantly enhancing access to high-quality healthcare services across the region.
What’s next for your company?
We have a significant expansion pipeline underway. Our biggest milestone will be the opening of our new 100,000 sq ft healthcare facility on Belfast’s Boucher Road. This state-of-the-art facility will expand access to high-quality, integrated, patient-centred medical services for the local community and surrounding regions
Alongside this, we will continue to expand our footprint across Ireland and the UK. We have an ambitious growth strategy and remain on track to double the size of the business over the next 24 months, while continuing to invest in innovative, community-based healthcare services.
Where do you want your business/brand to be this time next year?
We expect to have expanded our network further, with additional facilities open and an increased range of services, including more complex surgical care delivered in community-based settings.
What is the best book you’ve ever read (non-business) and why?
I don’t have a single standout book, but I particularly enjoy authors such as Bernard O’Brien and Wilbur Smith. Their work blends fiction with historical context in a way that brings different periods and parts of the world to life.
What is your favourite hobby and why?
I used to play hurling, but had to step away at 39 as my body had taken enough of its toll! These days, I enjoy spending time on the water, sailing or power boating. It is a very calming environment and a great way to unwind.
What is your mantra for life?
You get out of life what you put into it. For me, that means effort, attitude and consistency make a real difference over time. If you approach things with energy and a willingness to keep improving, you tend to create more opportunities for yourself.
It’s also a reminder that outcomes are usually the result of sustained effort and learning along the way, rather than chance.
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