Dáil Éireann Debate, Tuesday - 28 April 2026
1097. Deputy Ken O'Flynn asked the Minister for Health whether any discrepancies or inconsistencies in counselling activity reporting across health regions have been identified by her Department or the Health Service Executive in the past five years; and if she will provide details. [29909/26]
View answer1098. Deputy Ken O'Flynn asked the Minister for Health whether formal procedures exist for resolving disputes or inconsistencies in how counselling activity data is recorded or classified across health regions; and if she will make a statement on the matter. [29910/26]
View answer1101. Deputy Ken O'Flynn asked the Minister for Health whether counselling activity data reported by the Health Service Executive is independently verified or subject to external audit; and if she will provide details of any such processes. [29913/26]
View answer1109. Deputy Ken O'Flynn asked the Minister for Health the systems or controls in place at national level to identify, flag, and correct discrepancies or anomalies in counselling activity data submitted by Health Regions. [29921/26]
View answer1136. Deputy Ken O'Flynn asked the Minister for Health whether uniform national definitions are applied across all Health Service Executive regions in the recording of counselling activity, including definitions of referral, assessment, attendance, and discharge; and if she will provide details. [29949/26]
View answerI propose to take Questions Nos. 1097, 1098, 1101, 1109 and 1136 together.
As part of HSE Mental Health Services, the National Counselling Service provides free counselling therapy to adults who experienced childhood abuse or neglect, or are former residents of a mother and baby home. They also provide counselling to those with medical cards, through the Counselling in Primary Care service (CiPC). Outside of this, the HSE also funds many community partners to provide counselling and related services on its behalf. This is an area I have prioritised in recent Budgets, including €1m in Budget 2026 for a new talking therapies fund for providing Community Therapy Services.
There is a strong evidence base for the clinical effectiveness of CiPC, as demonstrated by Changing Lives for the Better: A National Evaluation of the Counselling in Primary Care (CIPC) Service (2022). This was the first national evaluation of the service and analysed data collected across all HSE Community Healthcare Organisations between 2015 and 2020, using routinely collected clinical outcome measures, follow-up data at 6 and 12 months, and feedback from clients and GPs. The evaluation found that 72% of clients improved or recovered following counselling, with large effect sizes, and that the proportion of clients assessed as being at risk reduced from 26.7% before counselling to 8.5% afterwards. Improvements in psychological distress, functioning and quality of life were largely maintained up to one year after counselling ended, and both clients and GPs reported high levels of satisfaction with the service, describing it as effective and beneficial.
Performance and Accountability Framework
Under the Health Service Executive (Governance) Act 2019, the Board of the Executive (the Board) is the governing body of the Health Services Executive (HSE), accountable to the Minister for Health and Minister for Children, Disability and Equality for the performance of its functions.
The Performance and Accountability Framework (PAF) sets out how the HSE is held to account for performance across Regions, National Services and HSE Centre functions. It is grounded in the Health Act 2004, which requires the HSE to deliver services efficiently, effectively, and equitably using public resources. The overarching goal is consistent, high-quality care nationwide, with less variation between regions and services
The Department of Health-HSE Performance Engagement Model facilitates Departmental oversight of delivery of the HSE National Service Plan, reform measures, and policy and projects that the HSE is tasked with delivering.
The HSE currently collects service-related mental health data which is used to compile the National Performance Report, which facilitates performance monitoring and oversight of mental health services.
The key performance indicators for mental health services are laid out in the HSE National Service Plan and are reported on by the HSE through the National Performance Report, which is received by the Department of Health on a monthly basis.
Departmental policy units, such as the Mental Health Policy Unit, have a monthly formal engagement with HSE counterparts to monitor activity and performance across services, and to identify any issues that require escalation.
My Department’s Performance Management Unit reports to the Management Board of the Department on overall performance on a monthly basis and tracks issues raised for escalation, and the actions agreed at higher level meetings
The next phase of implementation of the PAF will be the implementation of the Health System Performance Assessment Framework (HSPA), a new and more dynamic tool to monitor health system performance currently being rolled out by the Department of Health.
Counselling data
The HSE collects a wide range of data on service provision across HSE Mental Health Services. These key performance indicators (KPIs) are used by both the Department of Health and the HSE to monitor service performance against agreed targets and to support service planning and policy implementation. The data underpin Departmental performance engagement processes with the HSE, providing information to inform structured discussions on delivery, pressures and priorities. These KPIs are kept under ongoing review by the Department of Health and the HSE to ensure they continue to accurately reflect service provision and effectively support future service planning and development.
This includes a range of data on Counselling in Primary Care (CiPC) activity, including number of clients referred each month, number of re-referrals, waiting times for initial assessment and ongoing counselling, and the number of appointments offered. Re-referral data is captured through the service’s information management system by identifying subsequent referral events for the same service user after case closure, using unique client identifiers to link new episodes of care to prior service contacts.
The National Business Information Unit (NBIU), operating within HSE Community Health Care, is responsible for collating and analysing national performance and activity data across primary and community services. It is the unit that produces HSE Performance Reports, supports monitoring against the National Service Plan, and provides data for oversight by the National Planning Oversight Group and the Department of Health.
As outlined above, the HSE performance reports are essential to the performance monitoring work of the Department of Health and play a key role in service planning.
There is a pathway for Community Services Monthly Data and at various stages along this pathway data is quality checked and agreed, data is collated and reported, and queries are raised and explored. This is an iterative process and there may be various stages of checking and agreement before data is finally agreed by the NPOG at the end of the month and included in performance reports.
Activity data is submitted by CiPC to the NBIU in a standardised format using the approved Corporate Information Facility (CIF) template. Definitions for all data collected are set out in the HSE Mental Health Services Key Performance Indicator Metadata document.
Data validation begins at source. The National Counselling Service uses an electronic client management system that generates a standard report from which monthly activity data is compiled. Each Health Region then validates the submitted data for accuracy, completeness, and month-on-month consistency before forwarding it to the NBIU.
Digital for Care and Community Connect rollout
Community-based health and social care services have historically relied on a mix of paper records and local IT systems, which limited the availability of timely, consistent and reliable data at service, regional and national level.
To address these challenges, improvements in community data are being progressed as part of the HSE’s Digital for Care programme, which sets the national framework for digital health transformation. A key element of this work is Community Connect, the national programme delivering a single integrated digital solution for community services.
Community Connect is standardising how information on referrals, access, appointments, caseloads and activity is recorded across community settings. By shifting paper-based processes to a digital platform, the programme is improving the quality, availability and comparability of community data.
These changes will result in more accurate and timely information on service demand, activity and capacity, improved national and regional reporting and oversight, reduced duplication and administrative burden for staff, and better support for service planning, performance monitoring and policy development.
Community Connect also establishes national data standards across community services. This work aligns with the Digital for Care roadmap and represents a step towards the National Electronic Health Record (NEHR), ensuring that community data can be integrated with wider health service information over time. When fully rolled out, this work will benefit all community services, including counselling supports.
The Department of Health and the HSE are committed to improving the availability, quality and use of mental health data. In recent years, a range of initiatives has been progressed to strengthen multiple data sources that support performance monitoring, policy implementation and ongoing oversight, and which will inform the development of more effective mental health policies and services.
This work includes the development of an outcomes framework for Sharing the Vision, Ireland’s national mental health policy; the establishment of the National Probable Suicide Monitoring System, developed in collaboration with the Health Research Board; and the ongoing review and refinement of Key Performance Indicators (KPIs) used to support performance monitoring under the National Service Plan.
