Séamus Healy (Tipperary South, Workers and Unemployed Action Group)
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12. To ask the Minister for Health the actions he will take to end the practice by general practitioners of charging medical card holders for blood tests; and if he will make a statement on the matter. [48061/13]

Séamus Healy (Tipperary South, Workers and Unemployed Action Group)
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The Minister of State, Deputy White, said earlier that there is a lot happening in primary care, and indeed there is. Most GPs and their staff are working above and beyond the call of duty. However, that does not entitle GPs to put further pressure on ill, low-income patients with medical cards. Unfortunately, that is happening nowadays because GPs are charging for services that in the past were covered under the medical card service. I ask the Minister of State to ensure that the practice will be stopped.

Alex White (Dublin South, Labour)
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Under paragraph 11 of the general medical services or GMS contract, a general practitioner or GP shall provide for eligible persons, on behalf of the HSE, all proper and necessary treatment of a kind usually undertaken by a GP and not requiring special skill or experience of a degree or kind which GPs cannot reasonably be expected to possess. Under paragraph 27 of the GMS contract, a medical practitioner shall not demand or accept any payment or consideration whatsoever in reward for services provided by him or her, or for travelling or for other expenses incurred by him or her, or for the use of any premises, equipment or instruments in making the services available.

In circumstances where the taking of blood is necessary, either to assist in the process of diagnosing a patient or to monitor a diagnosed condition, the GP may not charge that patient if he or she is eligible for free GMS services under the Health Act 1970, as amended. The HSE has written to GP contract holders and clarified the position on this matter and has also communicated its position to the Irish Medical Organisation. Any alleged instances of eligible patients being requested to pay for a routine service of this nature from their own limited resources is viewed as a serious matter by the HSE and by the Department.

I have been advised by the HSE that its local health offices will fully investigate any reported incidents of eligible patients being charged for phlebotomy services which form part of the investigation and necessary treatment of patients' symptoms or conditions. In such cases, where a medical card holder or a GP-visit card holder has been inappropriately charged for the taking of blood, the HSE will make deductions from the routine GMS payments of those GPs.

Officials in my Department are in consultation with the HSE with a view to drawing up a new GP contract. The appropriate arrangements for phlebotomy services will be considered as part of the new contract.

Séamus Healy (Tipperary South, Workers and Unemployed Action Group)
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I appreciate the Minister of State's reply but because of the relationship between patients and GPs, it is difficult for individual patients to make complaints. The HSE and the Department of Health should initiate a procedure whereby GPs would not charge medical card holders for blood tests.

A number of other issues have also arisen in GPs' surgeries. The Irish Medical Organisation has indicated that general practitioners should charge for letters, which is now happening, and also for minor surgery. There is a significant issue concerning blood tests, but other matters are also coming down the tracks. The Department of Health should monitor the situation and initiate contacts with GPs and the IMO on this matter.

Alex White (Dublin South, Labour)
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As I said in my reply, we have communicated with the IMO and GP contract holders generally. I have heard of this issue coming up before as parliamentary questions have been tabled about it. The position is very clear in that a person cannot be charged for blood tests in circumstances where it is necessary to assist the process of diagnosis or to monitor a condition that has already been diagnosed.

I accept as Deputy Healy said that people may feel that it is hard for them as patients to make a complaint. We have made our position clear publicly, to the IMO and again here today by me. To the extent that it is necessary for it to be tightened up further contractually, we will address that when dealing with new contracts. All I can do is assure the Deputy that the position is that charges should never apply in the circumstances I have outlined. I have not addressed the secondary issue raised by the Deputy of letters and so on but I will have a look at it.