I propose to take Questions Nos. 169, 170 and 191 together.
There is no statutory obligation on the 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.
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 initiate a review of 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. This review is under way.
The Deputies' questions about the provision of chiropody services relate to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, 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 Deputies.