Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank Deputies Louise O'Reilly and Denise Mitchell for asking this question. There is no provision under the general practice general medical services contract for persons who hold a medical card or general practitioner visit card to be charged for routine phlebotomy services provided by their GP or a practice nurse on behalf of a GP, which are required to either assist in the diagnosis of illness or the treatment of a condition. The HSE has advised general practitioners that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card.

Notwithstanding this, I understand that in recent times some GPs have been charging GMS patients for these services. If a patient who holds a medical card or a GP visit card believes that he or she has been incorrectly charged for routine phlebotomy services by his or her GP that patient may make a complaint to the HSE local health office and it will deal with the matter in accordance with the complaints policy.

To achieve clarity on this issue, I have asked that any difference of perspective in regard to the provision of phlebotomy services be addressed in the GP contractual review process. I am pleased that initial meetings with GP representative bodies to progress this work have recently taken place and I look forward to constructive and positive further engagements. From my perspective, the rules under the existing contract are very clear - a GP should not be charging a medical card or GP visit card patient for such blood tests. The HSE's position is that in circumstances where the taking of blood is necessary to either assist in diagnosing or to monitor a diagnosed condition the GP may not charge a patient if he or she is eligible for free GMS services under the Health Act 1970. I understand this position is not accepted by GP representative bodies. To deal with GMS patient complaints regarding charges for phlebotomy services the HSE has put in place an arrangement whereby on receipt of a complaint from a patient or other representative or advocate it imposes a deduction on a GP's practice support subsidy payment and issues the patient a refund of the amount he or she has been charged by the GP for routine phlebotomy. The matter is further complicated by the fact that precise distinctions need to be made between what are deemed routine versus non-routine phlebotomy services. I do not have time to elaborate on that point but there is a difference between the two services.

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