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, having regard to their priorities within the funding allocated. Accordingly, chiropody services provided by health boards vary 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 a blood product or a blood transfusion and who have Health Amendment Act 1996 cards; and for persons with illnesses such as diabetes or arthritis. Persons must be referred for chiropody services by their general practitioner or public health nurse.
My Department has been made aware of the practice by a number chiropodists, particularly those in parts of the Eastern Regional Health Authority's area, of levying their medical card patients for services. The chairman of the chief executive officers group was asked last November to investigate the matter and revert to my Department in an effort to ascertain the level of this practice nationally. A reminder was sent to the group in December. Contact was made with the group again this week. The report is still being compiled and it should be available later this week.
Following receipt of a similar question in November, a letter was also sent to the regional chief executive of the Eastern Regional Health Authority asking that the matter should be investigated and pointing out that, since these extra charges were inappropriate, they should not be levied on eligible persons. The letter asked that the matter be investigated as a matter of urgency and a reply issued to the Deputy concerned as soon as possible.
My Department is undertaking an assessment of chiropodists for eligibility to practice in the public health service. This assessment should be completed by the end of May and should result in an increase in the number of chiropodists available to provide services to medical card holders. Contractual arrangements for the provision of chiropody services are a matter between the chiropodists concerned and the local health board.
