Health boards are not legally obliged to provide chiropody services to medical card holders. The formal position is that arrangements for the provision of services, including chiropody services, are a matter for the individual health boards to decide, having regard to their priorities within the funding allocated. Accordingly, chiropody services provided by health boards vary somewhat throughout the country but, usually priority is given to medical card holders who are aged 65 years and over, persons who have contracted hepatitis C directly or indirectly from the use of human immunoglobulin-anti-D, or from the receipt within Ireland of any blood product or a blood transfusion and who have Health Amendment Act 1996 cards, and for people with illnesses such as diabetes or arthritis.
A person must be referred for chiropody services by their general practitioner or a public health nurse and most boards provide three chiropody treatments per annum to all medical card holders over the age of 65 when considered clinically necessary. In some board areas the chiropody service is being delivered by voluntary agencies who provide the services in locations in the community e.g. day care centres, and to whom an allowance is paid by the health board. Domiciliary visits are made in some areas, if necessary.
My Department recently placed an advertisement in national newspapers inviting applications from chiropodists who wish to be assessed for eligibility to practice in the public health service. The assessment of these applications is being undertaken at present and a new updated list of chiropodists, considered eligible to practice in the public health service, should be available early in 2004. This should ensure a greater number of professionals available and easier access for patients.
