Catherine Byrne (Dublin South Central, Fine Gael)
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Question 387: To ask the Minister for Health and Children the situation regarding medical card holders, including old age pensioners, being required to pay top-up fees to chiropodists; and if she will make a statement on the matter. [1155/09]

Catherine Byrne (Dublin South Central, Fine Gael)
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Question 388: To ask the Minister for Health and Children, further to Parliamentary Question No. 232 of 4 June 2008, the situation regarding patients who hold a medical card being required to pay top-up fees for chiropody services; if she will commit to eliminating this extra fee for patients who should be entitled to a free chiropody service; and if she will make a statement on the matter. [1156/09]

Mary Upton (Dublin South Central, Labour)
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Question 507: To ask the Minister for Health and Children if she will review the payment to chiropodists for persons with medical cards; the reason that these persons are being asked to subsidise the medical card payment to the chiropodist; and if she will make a statement on the matter. [1990/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 387, 388 and 507 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.

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.

I have been advised by the HSE that, subject to consultation with IMPACT on non-fee aspects, which process is now nearing completion, it will be contacting chiropodists offering them interim contracts to provide services and advising them of the revised fees payable for such services. Accordingly, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the Deputy advised when this has been accomplished.

The HSE has also stated that its long term intention is to replace the interim contract with a substantive contract for the provision of chiropody services and that this will be progressed in line with national policy as it applies to private contractors.