Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 196: To ask the Minister for Health and Children if her attention has been drawn to the shortage of chiropodists here, in particular, the lack of training facilities for chiropodists and the fact that very few practising chiropodists will take medical card payments, in part due to a dispute with the Health Service Executive over fees and payments; the knock-on effect this has on the health and well-being of senior citizens and those with diabetes; the steps she is taking to resolve this problem; and if she will make a statement on the matter. [34900/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The FÁS "Healthcare Skills Monitoring Report" (2005) provided a quantitative analysis of demand and supply in 21 health care occupations including Chiropody/Podiatry. It highlighted podiatry as among those professions where current and future supply shortages should be addressed and recommended that a School of Podiatry providing 20 to 30 places be established. Meetings are continuing at an official level between my Department, the Department of Education and Science, the Higher Education Authority and the Health Service Executive to progress the matter. Responsibility for its establishment will be a matter, in the final instance, for the Department of Education and Science.

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. This process has been under way for some time and considerable progress has been made.

My Department is currently preparing legislation to clarify and update existing legislation on eligibility for health and personal social services. The Bill will define specific health and personal services more clearly; define who should be eligible for what services; set out clear criteria for eligibility; establish when and in what circumstances charges may be made and provide for an appeals framework.