Jack Wall (Kildare South, Labour)
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Question 188: To ask the Minister for Health and Children her views on the difficulties experienced by elderly people in public nursing homes in accessing chiropody services; the position regarding provision of chiropody services to elderly people through the medical card; her position on top up fees charged by chiropodists; and if she will make a statement on the matter. [6263/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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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. While considerable work has taken place to develop arrangements which would ensure that no top-up charges are applied, it is necessary to ensure that any such arrangements and the process by which they are arrived at comply with the terms of the Competition Act 2002. In this context legal advice is at present being sought in relation to the permissibility of negotiating contractual fee arrangements with organisations representing self-employed health professionals.

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.

As the Health Service Executive has the operational and funding responsibility for chiropody services, it is the appropriate body to consider the matter raised by the Deputy in relation to access to chiropody services for elderly people in public nursing homes. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have this matter investigated and to have a reply issued directly to the Deputy.