Dáil Éireann Debate, Tuesday - 28 April 2026
1076. Deputy Ken O'Flynn asked the Minister for Health whether her Department or the HSE has conducted any formal audit or validation exercise of counselling activity data reported under the Counselling in Primary Care and National Counselling Service programmes; if so, to provide the dates, scope, and findings of such audits. [29883/26]
Amharc ar fhreagra1078. Deputy Ken O'Flynn asked the Minister for Health whether all HSE Regional Health Areas apply identical definitions and classification criteria when reporting counselling activity data; and whether any regional variance or inconsistency has been identified. [29885/26]
Amharc ar fhreagra1079. Deputy Ken O'Flynn asked the Minister for Health whether the data collected on new referrals, re-referrals, and counselling sessions is published in a disaggregated and comparable format across regions; and if not, whether there are plans to do so. [29886/26]
Amharc ar fhreagra1080. Deputy Ken O'Flynn asked the Minister for Health whether the Department has assessed the reliability and decision-making suitability of counselling activity data currently reported through the Corporate Information Facility system. [29887/26]
Amharc ar fhreagra1081. Deputy Ken O'Flynn asked the Minister for Health whether any analysis has been carried out on the proportion of clients who re-refer to counselling services; the average number of re-referrals per client; and what this indicates regarding service effectiveness. [29888/26]
Amharc ar fhreagra1082. Deputy Ken O'Flynn asked the Minister for Health whether counselling activity data is linked to waiting list metrics, duration of care, or patient outcomes; and if not, whether there are plans to integrate such performance indicators. [29889/26]
Amharc ar fhreagra1084. Deputy Ken O'Flynn asked the Minister for Health whether her Department has considered transitioning from partially manual reporting systems to fully automated, standardised digital reporting for counselling services; and if so, the timeline for implementation. [29891/26]
Amharc ar fhreagra1085. Deputy Ken O'Flynn asked the Minister for Health the governance structures in place within her Department to oversee the accuracy, consistency, and policy usability of mental health counselling activity data reported by the HSE. [29892/26]
Amharc ar fhreagra1086. Deputy Ken O'Flynn asked the Minister for Health whether she considers the current arrangements for compiling and reporting counselling activity statistics within the Health Service Executive to constitute a sufficient national policy framework for ensuring consistency across health regions; and if she will make a statement on the matter. [29898/26]
Amharc ar fhreagra1087. Deputy Ken O'Flynn asked the Minister for Health whether any formal national policy, circular, or directive has been issued by her Department governing the standardisation of definitions used in counselling activity statistics, including client numbers, episodes of care, and activity totals; and if she will provide details. [29899/26]
Amharc ar fhreagra1088. Deputy Ken O'Flynn asked the Minister for Health the role of her Department in approving, reviewing, or overseeing the key performance indicator metadata definitions used by the Health Service Executive in reporting counselling activity; and if she will make a statement on the matter. [29900/26]
Amharc ar fhreagra1089. Deputy Ken O'Flynn asked the Minister for Health whether any assessment has been undertaken by her Department to determine the extent of variation in how counselling activity data is interpreted and reported across different health regions; and if she will make a statement on the matter. [29901/26]
Amharc ar fhreagra1090. Deputy Ken O'Flynn asked the Minister for Health whether her Department has conducted any audit or validation of counselling activity data submitted by health regions to ensure consistency, accuracy, and comparability at national level; and if she will make a statement on the matter. [29902/26]
Amharc ar fhreagra1091. Deputy Ken O'Flynn asked the Minister for Health whether the National Business Information Unit operates under a formally approved governance framework setting out responsibilities for data standardisation, validation, and escalation of discrepancies in counselling activity reporting; and if she will provide details on the matter. [29903/26]
Amharc ar fhreagra1092. Deputy Ken O'Flynn asked the Minister for Health whether any national guidance exists governing how counselling activity data should be interpreted for policy, planning, or funding decisions; and if she will make a statement on the matter. [29904/26]
Amharc ar fhreagra1093. Deputy Ken O'Flynn asked the Minister for Health whether her Department has examined whether differences in data definitions or reporting practices across health regions may impact national waiting list data, service planning, or resource allocation in counselling services; and if she will provide details. [29905/26]
Amharc ar fhreagra1094. Deputy Ken O'Flynn asked the Minister for Health whether any plans are in place to introduce a formal national policy framework governing the compilation, validation, and reporting of counselling activity statistics across the Health Service Executive; and if she will make a statement on the matter. [29906/26]
Amharc ar fhreagra1095. Deputy Ken O'Flynn asked the Minister for Health the mechanisms in place within her Department to ensure that national mental health service performance data, including counselling activity statistics, is based on consistent and standardised definitions across all health regions; and if she will provide details. [29907/26]
Amharc ar fhreagra1096. Deputy Ken O'Flynn asked the Minister for Health whether responsibility for defining and maintaining counselling activity metrics within the Health Service Executive rests at national or regional level; and if she will clarify the governance structure in place. [29908/26]
Amharc ar fhreagra1099. Deputy Ken O'Flynn asked the Minister for Health whether the corporate information facility templates used for counselling activity reporting are subject to periodic review and approval at Department level; and if she will provide details of such reviews. [29911/26]
Amharc ar fhreagra1100. Deputy Ken O'Flynn asked the Minister for Health whether her Department has issued any guidance on the minimum data standards required for counselling services to ensure national comparability and transparency; and if she will make a statement on the matter. [29912/26]
Amharc ar fhreagra1102. Deputy Ken O'Flynn asked the Minister for Health whether any evaluation has been undertaken to assess whether current data reporting arrangements adequately support evidence-based policymaking in mental health counselling services; and if she will provide details of same. [29914/26]
Amharc ar fhreagra1103. Deputy Ken O'Flynn asked the Minister for Health whether the absence of a formal national policy governing counselling activity statistics has been identified as a governance risk within her Department or the Health Service Executive; and if she will make a statement on the matter. [29915/26]
Amharc ar fhreagra1104. Deputy Ken O'Flynn asked the Minister for Health whether her Department intends to align counselling activity reporting standards with broader national health data governance frameworks; and if so, to provide a timeline for such alignment. [29916/26]
Amharc ar fhreagra1105. Deputy Ken O'Flynn asked the Minister for Health whether any international benchmarking has been undertaken in relation to the governance and standardisation of counselling activity data; and if she will provide details. [29917/26]
Amharc ar fhreagra1106. Deputy Ken O'Flynn asked the Minister for Health whether any national-level audit, verification, or quality assurance process is conducted by or on behalf of her Department or the Health Service Executive in respect of counselling activity data submitted by health regions; and if so, to provide details of the scope, frequency, and findings of such processes. [29918/26]
Amharc ar fhreagra1107. Deputy Ken O'Flynn asked the Minister for Health whether any independent or internal audit of counselling activity data systems has been conducted since 2020; and if so, to provide the dates, scope, and outcomes of each such audit. [29919/26]
Amharc ar fhreagra1108. Deputy Ken O'Flynn asked the Minister for Health which unit, division, or office holds ultimate responsibility for assuring the accuracy, consistency, and completeness of national counselling activity data. [29920/26]
Amharc ar fhreagra1110. Deputy Ken O'Flynn asked the Minister for Health whether the Health Service Executive maintains any metric, estimate, or benchmark regarding the rate of error or data inconsistency in counselling activity reporting; and if so, to provide such data. [29922/26]
Amharc ar fhreagra1111. Deputy Ken O'Flynn asked the Minister for Health whether the Comptroller and Auditor General, internal audit, or any external body has examined or reviewed the systems used to collect and verify counselling activity data; and if so, to provide details.; and if she will make a statement on the matter. [29923/26]
Amharc ar fhreagra1112. Deputy Ken O'Flynn asked the Minister for Health whether standardised national protocols exist governing the validation and verification of counselling activity data prior to submission to the National Business Information Unit; and if so, to provide details. [29924/26]
Amharc ar fhreagra1113. Deputy Ken O'Flynn asked the Minister for Health the steps been taken to mitigate the risk of human error arising from the manual processes involved in counselling activity data collection and submission. [29925/26]
Amharc ar fhreagra1115. Deputy Ken O'Flynn asked the Minister for Health whether counselling activity data submitted to the National Business Information Unit is used to inform national policy, funding allocations, or service planning; and if so, the assurance mechanisms that are in place to ensure the reliability of such data. [29927/26]
Amharc ar fhreagra1116. Deputy Ken O'Flynn asked the Minister for Health whether her Department collects or requires reporting on the number of unique individuals receiving counselling services under the National Counselling Service, as distinct from the total number of counselling sessions reported. [29928/26]
Amharc ar fhreagra1117. Deputy Ken O'Flynn asked the Minister for Health whether she is satisfied that reporting counselling activity on the basis of total sessions, rather than unique patients, provides an accurate basis for service planning and policy development. [29929/26]
Amharc ar fhreagra1118. Deputy Ken O'Flynn asked the Minister for Health whether her Department has conducted any analysis comparing total counselling sessions delivered with the number of individual service users; and if so, to provide the findings. [29930/26]
Amharc ar fhreagra1119. Deputy Ken O'Flynn asked the Minister for Health whether the current KPI framework for counselling services includes any requirement to report average number of sessions per client; and if not, whether this will be introduced. [29931/26]
Amharc ar fhreagra1120. Deputy Ken O'Flynn asked the Minister for Health whether any independent audit or external validation has been carried out on National Counselling Service activity data in the past five years; and if so, to provide details. [29933/26]
Amharc ar fhreagra1121. Deputy Ken O'Flynn asked the Minister for Health the extent to which manual data handling processes are involved in the compilation of counselling service statistics; and whether her Department has assessed the associated risk of data error or inconsistency. [29934/26]
Amharc ar fhreagra1122. Deputy Ken O'Flynn asked the Minister for Health whether her Department has issued any formal guidance or standards governing how counselling activity data should be recorded, validated, and reported across Health Regions. [29935/26]
Amharc ar fhreagra1124. Deputy Ken O'Flynn asked the Minister for Health whether she will commit to introducing a standardised national reporting framework that includes both session-level activity and unique patient-level metrics for counselling services [29937/26]
Amharc ar fhreagra1125. Deputy Ken O'Flynn asked the Minister for Health whether her Department maintains any central dataset capturing the total number of individuals accessing State-funded counselling services annually, and if not, the reason for same [29938/26]
Amharc ar fhreagra1126. Deputy Ken O'Flynn asked the Minister for Health whether any international benchmarks or best practice standards have been considered in the design of Ireland's counselling service reporting framework. [29939/26]
Amharc ar fhreagra1127. Deputy Ken O'Flynn asked the Minister for Health whether she considers the current reporting model sufficient to assess waiting list pressures and unmet demand within counselling services. [29940/26]
Amharc ar fhreagra1128. Deputy Ken O'Flynn asked the Minister for Health whether her Department has assessed whether multiple attendances by the same individual within a reporting period may distort national activity figures, and if so, to provide details. [29941/26]
Amharc ar fhreagra1129. Deputy Ken O'Flynn asked the Minister for Health whether any reforms are planned to align counselling service reporting with outcome-based or patient-centred metrics, rather than activity-based metrics alone. [29942/26]
Amharc ar fhreagra1130. Deputy Ken O'Flynn asked the Minister for Health whether the National Business Information Unit or any other body conducts consistency checks or reconciliations across regional submissions for counselling data. [29943/26]
Amharc ar fhreagra1131. Deputy Ken O'Flynn asked the Minister for Health whether any discrepancies or anomalies in counselling activity reporting have been identified in the past three years, and how these were addressed. [29944/26]
Amharc ar fhreagra1132. Deputy Ken O'Flynn asked the Minister for Health whether she will provide a breakdown of counselling activity by new versus returning clients, if such data is available. [29945/26]
Amharc ar fhreagra1133. Deputy Ken O'Flynn asked the Minister for Health whether her Department has considered publishing transparent public reports distinguishing between total sessions delivered and total individuals treated. [29946/26]
Amharc ar fhreagra1134. Deputy Ken O'Flynn asked the Minister for Health whether she will commit to a review of data governance arrangements underpinning mental health service reporting, including counselling services. [29947/26]
Amharc ar fhreagra1135. Deputy Ken O'Flynn asked the Minister for Health whether her Department maintains or has access to a single, centralised national dataset capturing total counselling activity across all Health Service Executive regions; and if not, the reason for same. [29948/26]
Amharc ar fhreagra1137. Deputy Ken O'Flynn asked the Minister for Health whether her Department has assessed the extent to which counselling activity data reported by individual Health Service Executive regions is directly comparable on a like-for-like basis; and if so, the findings of that assessment. [29950/26]
Amharc ar fhreagra1138. Deputy Ken O'Flynn asked the Minister for Health whether any national-level validation, reconciliation, or consistency checks are applied to counselling activity data submitted by Health Service Executive regions; and if she will outline the mechanisms in place. [29951/26]
Amharc ar fhreagra1139. Deputy Ken O'Flynn asked the Minister for Health whether counselling activity data collected by the Health Service Executive is subject to periodic internal audit or independent external audit; and if so, the frequency, scope, and most recent findings. [29952/26]
Amharc ar fhreagra1140. Deputy Ken O'Flynn asked the Minister for Health whether her Department has assessed the risk that multiple attendances by the same individual within a reporting period may lead to inflated activity figures in counselling service reporting; and if so, the outcome of that assessment. [29953/26]
Amharc ar fhreagra1141. Deputy Ken O'Flynn asked the Minister for Health whether any national reporting framework for counselling services includes outcome-based or patient-centred metrics, in addition to activity-based measures; and if she will provide details. [29954/26]
Amharc ar fhreagra1142. Deputy Ken O'Flynn asked the Minister for Health whether her Department has established any formal governance framework to ensure consistency, accuracy, and completeness of counselling service data across Health Service Executive regions; and if she will outline same. [29955/26]
Amharc ar fhreagra1143. Deputy Ken O'Flynn asked the Minister for Health whether any timelines, milestones, or implementation targets have been set under the Digital for Care 2030 framework in relation to the development of standardised national reporting for counselling services; and if she will provide details. [29956/26]
Amharc ar fhreagra1144. Deputy Ken O'Flynn asked the Minister for Health whether her Department has conducted any gap analysis between current counselling service reporting practices and international best practice standards for health service data reporting; and if so, the findings and any actions arising. [29957/26]
Amharc ar fhreagraI propose to take Questions Nos. 1076, 1078 to 1082, inclusive, 1084 to 1096, inclusive, 1099, 1100, 1102 to 1108, inclusive, 1110 to 1113, inclusive, 1115 to 1122, inclusive, 1124 to 1135, inclusive, 1137 to 1144 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.
Mental Health policy and outcomes measurement
Sharing the Vision – A Mental Health Policy for Everyone, and Connecting for Life, Ireland’s national strategy for suicide prevention, clearly state that talk therapies should be considered a first-line treatment option for most people who experience mental health difficulties.
The Department of Health and the HSE are working to develop an outcomes framework to support the monitoring of the implementation of Sharing the Vision: A Mental Health Policy for Everyone. Part of this work involves the design and development of policy outcomes monitoring and tracking processes, including of population-level indicators.
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.
The Statistics and Analytics Unit within the Department of Health is responsible for strengthening evidence-based policymaking through the production, analysis and dissemination of high quality health statistics and analytical outputs. Its core aim is to improve the availability, accessibility and use of health information to support policy development, monitoring, evaluation and planning across the health system.
The Unit leads on national health data publications, international statistical reporting, and the development of Health System Performance Assessment, operating in line with national and EU statistical standards. Its work supports policy development, monitoring and evaluation, while promoting transparency and access to high quality health information.
Counselling data in the Public Service Performance Report
Drawing on the counselling data outlined above, the Department of Health reports on a defined set of CiPC metrics within the Public Service Performance Report under the Equality Budgeting framework maintained by the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation. A selection of mental health KPI’s are reported on through the Public Service Performance Report, which provides an annual review of delivery of public services.
The Public Service Performance Report (PSPR) is the Government’s annual, whole of public service assessment of performance. It provides a consolidated view of what Ireland’s public services have delivered over the year, drawing on data and indicators from across Government Departments and agencies. The report focuses on outcomes, service quality, as well as activity.
The Public Service Performance Report plays a central role in demonstrating how public services are performing, how public money is being used, and how Government action contributes to wellbeing and equality outcomes.
The PSPR includes equality budgeting metrics to show how public spending and services affect different groups across society. These metrics support the integration of equality considerations into budgeting and performance reporting, helping to identify whether policies are contributing to more fair and inclusive outcomes. The metrics focus on service reach, referral pathways and access, particularly for groups experiencing social or economic disadvantage. Their inclusion helps demonstrate whether public funding is contributing to more equitable access to timely, early mental health supports.
CiPC is presented as an equality measure as it provides free, timely access to counselling to medical card holders supports in primary care, reducing financial and structural barriers to mental health services. By supporting early intervention and ensuring access based on need rather than ability to pay, the service contributes to addressing inequalities in mental health outcomes, particularly for people experiencing social or economic disadvantage.
Therapeutic Interventions Service Improvement Programme Board
The HSE have recently established a therapeutic interventions service improvement programme board (TISIP). The programme board will provide consolidated leadership and governance for therapeutic interventions across the whole health system, with the aim of increasing capacity, and facilitating access to, high quality integrated supports and services for all who require them.
Specifically, the TISIP will provide
• The means to align efforts towards universally accessible talk therapies
• Greater consistency of approach and standards in service provision
• Stronger oversight and leadership
• Delivery models that are better integrated and coordinated from the outset, and can remove obstacles associated with levels of care if required and clinically appropriate
• Potential to further assess and develop partnership and multi-agency working, and shared-care arrangements
• A programme board to consider and review proposals for further investment in this area.
Future additional investment in counselling provision will be guided by a mapping of current services provided directly by the HSE or through organisations funded by HSE Mental Health and HSE NOSP. This investment will target identified gaps in service provision and take account of priority groups across the population.
As Minister I am satisfied with the effectiveness of the CiPC service, and with the administration of the service, including data collection and validation and how this informs my Department’s policy making and decisions on investment in the annual Estimates process. I continue to invest in CiPC and other State funded counselling supports, including €2 million in funding announced in 2025 to provide access to a suite of new talk therapies and counselling supports specifically tailored for men. Access to the services began from September 2025 and to date over 1,200 men have been supported.
The funding is targeted at assisting with stigma reduction and to actively encourage men who otherwise would not usually avail of counselling to seek help with their mental health, to assist men in accessing mental health services, and to provide much-needed support for men experiencing a mental health crisis.
