The hospital's fundamental purpose is the delivery of health treatment, care and diagnose as well as health promotion and preventative services at catchment, regional, super-regional and national levels. Its service remits ranges in complexity from secondary to tertiary level.

St. James's hospital is also an academic teaching hospital. It is thus committed to the creation of an environment and the circumstances in which education and research in the health science and allied areas is possible and flourishes.

The Hospital is increasingly required to operate in an environment of vertical and literal collaboration in the ultimate interest of its patients. It advocates and pursues the promotion and participation of the hospital in services and academic health networks, both nationally and internationally, in this context.