Richard Bruton (Dublin North Central, Fine Gael)
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Question 220: To ask the Minister for Health and Children the reason chiropody is not regarded as a core element of entitlement for medical card holders; her views on entering into a contract with chiropodists in order that medical card holders would not find themselves restricted in the use of chiropody services and obliged to pay top-up fees to chiropodists for access to the service; and if she will make a statement on the matter. [9650/08]

Eamon Gilmore (Dún Laoghaire, Labour)
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Question 235: To ask the Minister for Health and Children the reason medical card holders are being requested to pay a top up charge when they attend a chiropodist for treatment; and if she will make a statement on the matter. [8825/08]

James Reilly (Dublin North, Fine Gael)
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Question 241: To ask the Minister for Health and Children the eligibility for medical card holders, particularly pensioners and card holders on disability allowance to access chiropodist care; if the cost of such care is fully covered by the medical card; and if she will make a statement on the matter. [8849/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 220, 235 and 241 together.

There is no statutory obligation on the Health Service Executive (HSE) to provide chiropody services to GMS patients; however in practice arrangements have been made in several regions to provide these services. Before the establishment of the HSE the nature of any arrangements for community chiropody services and the level of service provided were a matter for individual health boards and so a degree of variation in practice developed over time. I understand that 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.

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.

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.