Grace Boland (Dublin Fingal West, Fine Gael)
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2561. To ask the Minister for Health if she will give due consideration to expanding Ireland’s medical card scheme to cover psychotherapy, both short-term and long-term, through a reimbursement model for accredited private therapists, as currently medical card holders can access up to eight free counselling sessions via the HSE’s Counselling in Primary Care programme, which does not address those who suffer from chronic health conditions requiring ongoing therapy; and if she will make a statement on the matter. [40859/25]

Mary Butler (Waterford, Fianna Fail)
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In line with Ireland's national mental health policy, Sharing the Vision - A Mental Health Policy for Everyone, and the objectives of Sláintecare, the long-term vision is to establish universal access to counselling. Funding allocated under Budget 2025 will allow mental health services to move in the direction of universal access by extending current eligibility.

Under Budget 2025, €2m was allocated to the National Counselling Service for the expansion of Counselling in Primary Care (CiPC).

All service users will benefit, but a particular focus will be placed on encouraging engagement by men with counselling services.

CiPC offers a structured counselling programme of up to eight sessions, in addition to an initial assessment. The service is offered through a range of platforms (face to face; online; phone) to ensure ease of access for clients.

There is a strong evidence base for the clinical effectiveness of the service, as demonstrated by Changing Lives for the Better: A National Evaluation of the Counselling in Primary Care Service (2022).

Expanding access to talk therapies is a key objective of Sharing the Vision, guided by which there has been a significant scaling up of online guided programmes based on cognitive behavioural principles, which are now benefiting up to 10,000 people every year. As part of the 2025-2027 Implementation Plan for the policy, it is aimed to see the establishment of a person-centred delivery model for talk therapies in primary care and community settings, taking into account available supports including HSE Primary Care Psychology and CiPC.

Regarding access to medical cards: medical card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.

The issue of granting medical cards on the basis of illness or a disability was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.

To the extent that this is a service matter, this has been referred to the HSE for direct response.