Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank the Deputy for raising this important issue. Persons who are eligible for GP care without charge under the Health Act 1970 are not subject to co-payments or other charges in respect of such services. There is no provision under the general medical services, GMS, GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP that are required to assist either in the diagnosis of illness or in the treatment of a condition. The HSE has advised GPs that where a blood test forms part of an 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. Routine blood tests that are deemed clinically necessary by the patient's GP are comprehended by the scope of this service.

Notwithstanding this, the Minister, Deputy Donnelly, is aware that some GPs are charging GMS patients for phlebotomy services in some instances. The issue of charging GMS patients for phlebotomy services is complex, given the numerous reasons and circumstances under which blood tests are taken. The matter is further complicated by the fact that it is difficult to make precise distinctions between routine and non-routine phlebotomy services.

It is a matter for the treating GP to determine in the case of each individual patient what is proper and necessary care. In circumstances where a GP determines that a particular treatment or service requested by a patient is not clinically necessary but the patient still wishes to receive same, it is at the GP's discretion as to whether a charge is imposed for providing the service. The GP chronic disease management programme will involve the ongoing monitoring of patients' condition, and any blood test required in this context will be covered by the fees payable for this care. Where a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services that he or she should have received without charge, he or she should report this to the HSE local primary care management, which will investigate the matter.

The role of local primary care management within each community healthcare organisation, CHO, is to investigate in the first instance the validity of any claim a GMS patient makes regarding charges inappropriately levied by his or her GP of choice for blood tests undertaken at the GP's practice as part of the investigation and necessary treatment of the patient's symptoms or condition. If it is established an inappropriate charge was levied on the patient for routine phlebotomy services, the HSE primary care eligibility and reimbursement service, PCERS, is notified accordingly. PCERS will, based on the recommendation of the local health manager, make a full refund to the patient concerned. Given the complexity of the issue, it is not possible to further streamline the process of seeking refund for blood test charges.

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