Anthony Lawlor (Kildare North, Fine Gael)

I thank the Ceann Comhairle for giving me the opportunity to raise this issue and the Minister of State for being in attendance. The issue I wish to raise was brought to my attention in my clinics a few weeks ago by an elderly couple who explained to me that they were both in need of regular blood tests because one of them was on warfarin which required regular blood testing, while the other needed blood tests owing to a diagnosis. They told me that they both had medical cards and that they were being charged by different GPs for having the tests done. They were both visibly upset when they told me this because they believed they should not be charged for this facility as they both had medical cards.

When they left the office, we conducted some research. We rang a number of GPs in Kildare and found out that while a few doctors were not charging patients for this facility, a number were charging between €20 and €45, even though it should be provided free of charge. Doctors claimed they were charging for the service because it was taking time for them to carry out blood tests. The health correspondent of the Irish Independent, Eilish O'Regan, wrote than in some cases it could take up to 20 minutes to carry out a blood test. Was blood being taken from a stone? Other reasons for charging included the cost of transporting blood samples to laboratories. If a doctor takes five blood samples per day and is charging €40 per patient, for €200 I would pick up the blood samples on my bicycle and bring them to the laboratory. It seems ridiculous.

I wrote to the HSE to confirm if the practice of charging for these services was allowed. It sent me a letter on 17 May. It stated:

It is a general practitioner's contractual responsibility to provide proper and necessary treatment to eligible persons. If part of that proper and necessary treatment, as referred to above, includes routine phlebotomy, the GP must provide that service free of charge under the terms of his or her contract. The HSE has written to GP contract holders and clarified the position on this matter, and has also communicated the position to the Irish Medical Organisation.

I have also a letter the HSE sent on 20 June 2011 which clearly states GPs should not be charging medical card holders for these services. There is a response on MediLearning.ie from Dr. Mary Gray, the spokesperson for GPs on the IMO committee. She stated the following:

This position was notified to the Department of Health and Children in 2009 and 2010 in IMO submissions on the Financial Emergency Measures in the Public Interest Act. The matter was further clarified in correspondence with the Minister for Health and Children ... It was not a matter of dispute between the parties and we therefore strongly reject any suggestion that GPs are acting outside of the terms of the GMS contract.

Therefore, the IMO believes doctors should charge for the service, while the HSE believes they should not. People are at loggerheads and there seems to be no solution forthcoming either from the HSE or the IMO. This has been ongoing since 2009. At the end of the day, do we expect patients who have built a long-term relationship with their doctors to ring the HSE and make a complaint? I find it very difficult to believe. The direction should come from the HSE. Those who are suffering are the sick and the elderly, the people for whom we have to care.

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