I propose to take Questions Nos. 260 and 264 together.
Section 469 of the Taxes Consolidation Act 1997 provides for tax relief in respect of qualifying health expenses.
Section 469 defines "health expenses" as "expenses in respect of the provision of health care including the services of a practitioner".
A practitioner is defined in the section as "any person who is:
1. registered in the register established under section 43 of the Medical Practitioners Act 2007,
2. registered in the register established under section 26 of the Dentists Act, 1985, or,
3. in relation to health care provided outside the State, entitled under the laws of the country in which the care is provided to practice medicine or dentistry there".
In the case of counselling or psychotherapy, the relief is available where the counsellor, psychologist or psychotherapist carrying out the treatment is a qualified practitioner, or where a patient is referred by a qualified practitioner for a diagnostic procedure.
This is similar to the position that applies to other medical expenses, and I am satisfied that the legislation provides sufficient flexibility for expenses that should qualify for tax relief. Accordingly, there are no plans to change these arrangements at this time.
Comprehensive guidance material on medical expenses can be found on Revenue’s website in Tax and Duty Manual Part 15-01-12 www.revenue.ie/en/tax-professionals/tdm/income-tax-capital-gains-tax-corporation-tax/part-15/15-01-12.pdf
With regards to the application of VAT exemption now rated at 13.5% on earnings over €37,500 for counsellors and psychotherapists, the VAT rating of goods and services is subject to the requirements of EU VAT law, with which Irish VAT law must comply. Under domestic legislation, professional medical care services recognised as such by the Department of Health are exempt from VAT. Professional medical care services recognised by the Department of Health are generally those medical care services supplied by health professionals who are enrolled, registered, regulated, or designated on the appropriate statutory register provided for under the relevant legislation in force in the State or equivalent legislation applicable in other countries. This includes health professionals registered under the Medical Practitioners Act 2007, the Nurses Act 1985 and those engaged in a regulated profession designated under Section 4 of the Health and Social Care Professionals Act 2005.
Statutory Instrument No. 170 of 2018 (Health and Social Care Professionals Act 2005 (Regulations 2018) of 2 July 2018 designates psychotherapists and counsellors as a regulated profession and established the Counsellors and Psychotherapists Registration Board. Professional counselling and psychotherapy services provided by persons registered by this Board are exempt from VAT from the date of their registration.
The thirteen members of the Counsellors and Psychotherapists Registration Board were appointed with effect from 25 February 2019.
The Board has begun the substantial body of work which must be undertaken before it is in a position to open its registers. Questions on the establishment of the Counsellors and Psychotherapists Registration Board and their progress in opening their register are a matter for the Minister for Health.
I am informed by Revenue that VAT returns do not require traders to separately identify specific product or service types (such as counselling and psychotherapy services). Therefore, there is no information available to Revenue on which to estimate the cost to the Exchequer of exempting these activities from VAT.