Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 209: To ask the Tánaiste and Minister for Health and Children when a review will take place of the current agreement with the Society of Chiropody Ireland in relation to payment for treatment of medical card patients; the terms of reference and the report deadline; and if she will make a statement on the matter. [28032/06]

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 214: To ask the Tánaiste and Minister for Health and Children if her attention has been drawn to the practice of some chiropodists charging a levy on medical card holders to recoup costs not covered by the Health Service Executive; if her attention has further been drawn to the fact that more chiropodists are planning to introduce such a levy and that others are leaving Ireland to practice abroad; and if she will make a statement on the matter. [28037/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 209 and 214 together.

There is no statutory obligation on the Health Service Executive (HSE) to provide chiropody services to GMS patients; however in practice arrangements are made to provide these services. Before the establishment of the HSE the nature of the arrangements for chiropody and the level of service provided was a matter for individual health boards and so a degree of variation in practice developed over time. Priority is usually given to certain groups of people, including people who are medical card holders aged 65 years and over. In several regions the service is provided by private chiropodists by arrangement with the HSE.

I consider that it is inappropriate for private chiropodists who are providing services on behalf of the HSE to charge patients a top-up fee, and I have conveyed this view formally to the HSE. My Department requested the HSE to review the fee arrangements in place for the provision of chiropody services, with a view to ensuring that such additional fees will no longer be levied on persons in receipt of this service; and this process is well under way with the aim of expediting appropriate agreement at the earliest opportunity.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 210: To ask the Tánaiste and Minister for Health and Children the steps which have been taken to establish a school and an associated degree course for students to study chiropody here. [28033/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Given the importance of securing a supply of chiropodists/podiatrists domestically to match the growth in demand for chiropody services, I am conscious of the need to establish a school of podiatry in the State.

Although responsibility for the establishment of a school of podiatry will be a matter, in the final instance, for the Department of Education and Science, the delivery of clinical training, which is a significant core component of the course, has been the subject of discussions between officials of my Department and the Department of Education and Science in terms of how best it could be facilitated in an integrated fashion with Health Service Executive (HSE) services. The HSE has submitted its proposals on how to provide the clinical training associated with a podiatry degree programme and these proposals were discussed at the most recent meeting between officials which took place on 21 June. Both Departments are continuing to progress the matter.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 211: To ask the Tánaiste and Minister for Health and Children the number of registered chiropodists here; the number of Irish students of chiropody attending English colleges; and if she will make a statement on the matter. [28034/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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There are no statutory registration requirements for chiropodists in Ireland. However, the Deputy may wish to note that the Health Service Executive is responsible for the maintenance of a list of chiropodists considered eligible to practise in the public health service. There are 228 chiropodists on this list.

An assessment process to update this list is currently under consideration by the Health Service Executive and is likely to commence shortly.

My Department does not hold any information on the numbers of Irish people studying chiropody in English colleges. The Deputy may wish to note that officials from my Department are working closely with officials from the Department of Education and Science with a view to establishing a school of podiatry in the State.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 212: To ask the Tánaiste and Minister for Health and Children when the payment to chiropodists who treat medical card patients will be benchmarked; when the payment from the Health Service Executive will be increased in line with inflation in general and medical inflation in particular. [28035/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I assume that the Deputy is referring to fees paid by the Health Service Executive to private chiropodists for providing services to medical card holders as opposed to chiropody grades employed by the Executive. Pay increases recommended by the Public Service Benchmarking body have been implemented for chiropodists employed in the public service. These pay increases are not applicable to private chiropodists.

My Department requested the HSE to review the fee arrangements in place for the provision of chiropody services and this process is well under way.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 213: To ask the Tánaiste and Minister for Health and Children the role she sees for chiropodists in the primary care networks proposed by the Health Service Executive; and if she will make a statement on the matter. [28036/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Government is fully committed to the implementation of the principles contained in the Primary Care Strategy and this includes the development of primary care teams and networks. The implementation process at operational level is a function of the Health Service Executive, whose Chief Executive Officer has identified as a priority the development of multidisciplinary primary care services, both as the appropriate service to meet people's health and social care needs and to complement the services provided by acute hospitals.

The 2006 Estimate for the HSE includes an additional €10 million in revenue funding to enable the establishment of up to 100 new primary care teams. This will enable the provision of some 300 additional frontline personnel to work alongside GPs in order to provide integrated and accessible services in the community. Work by the HSE to establish these teams is under way. In planning for the establishment of these teams, the Executive intends to focus where possible on areas of disadvantage and with significant health inequalities.

The HSE will also, as part of the ongoing restructuring and reorientation of resources nationally, work towards the establishment of primary care networks of health and social care professionals that will include chiropodists.

Ongoing implementation of the Primary Care Strategy will focus on the reorganisation of the resources already available to the health service and on developing new ways of working in line with the service model described in the Strategy. This whole-system approach to implementation means change will be required in many sectors in the health service, and not solely within primary care. It is within this context that additional resources can be deployed to best effect.