Dominic Hannigan (Meath East, Labour)

I thank the Ceann Comhairle's office for giving me the opportunity to raise the issue and I thank the Minister of State, Deputy Shortall, for taking the matter.

The charging of medical cardholders for blood tests was raised with me just after the general election in February. A couple were asked to pay for a blood test even though they were in possession of a valid medical card. Of course they paid because they were worried about their health and felt that failure to pay would result in failure to have a test, resulting in the illness going undiagnosed or untreated. They were confused and decided to pay as of course they would.

They worried about how they could afford it and whether this was just the start of a creeping system whereby they would pay for more and more services while at the same time being in possession of a medical card. I know they were not the only couple as others across County Meath have contacted me, and I believe it is common in other counties for GPs to charge people for taking blood, even though those people have medical cards.

At present, one in every three people in the country has a medical card or a GP card, and this number has been increasing since the start of the recession. The HSE's figures suggest that by the end of this year up to 40% of the population will be in receipt of a medical card. The overall cost of the GMS scheme to the Exchequer was just under €2 billion in 2009 and payments to GPs under the scheme total approximately €500 million every year. Some 2,100 GPs are in receipt of a GMS contract and the average payment to each of them is approximately €225,000. Payments vary throughout the country but, of course, on top of those payments GPs are also entitled to take on private clients, so the total payments going into a GP's practice could typically be of the order of €400,000 to €500,000 per year.

There was an 8% cut to the payment a couple of years ago and the Irish Medical Organisation argues that this makes it more difficult for GPs to provide services. However, not one GP has opted out of the GMS contract so, clearly, it is not that difficult to cater for the 8% cut. It is intolerable and unfair that GPs are asking vulnerable people to pay a blood test charge, which is a direct attack on poor people. Personally, I am disgusted any doctor would do this.

I am glad to see the Minister of State, Deputy Shortall, in the House. We need to have clarity on this issue so I ask the Minister of State to outline the situation and clarify whether GPs have the right to charge people with medical cards for blood tests, what they can charge for and whether the Minister will be issuing guidance in this regard so we can clear up the matter once and for all.

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