Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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8. To ask the Minister for Health if he acknowledges the level of uncertainty and the lack of clarity pertaining to the practice of general practitioners charging medical card holders for blood tests; if he is aware that General Medical Service patients are being charged, despite the fact that under the Health Act 1970, it is stated a general practitioner may not charge the patient if the patient is eligible for free general medical services, including in the event that a patient needs bloods to be taken to either assist in the process of diagnosis or monitor a diagnosed condition; his plans to address the level of ambiguity and confusion among medical card holders and general practitioners alike; and if he will make a statement on the matter. [42904/15]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I seek to establish the level of the Minister of State's awareness of the uncertainty and the lack of clarity surrounding general practitioners charging medical card holders for blood tests. What steps are being taken to eliminate the ambiguity in this matter?

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for raising this issue. While most GPs provide phlebotomy services for their medical card and GP visit card patients without charge, I am aware that there have been instances where some GPs have charged such patients for these services. It is not acceptable for patients in these categories to be subject to a charge for procedures associated with routine diagnosis and treatment.

The HSE, as the body which contracts GPs for the provision of services for GMS and GP visit card patients, has written on a number of occasions to contract holders, most recently in March 2014, clarifying the position on phlebotomy services. All written complaints about GPs charging for such services have been investigated by the HSE. In any case where a patient has been charged by his or her GP for phlebotomy services, the HSE will, where appropriate, arrange for a refund of the amount concerned.

The Department of Health and the HSE are cognisant of the need for a new agreed contract with GPs that will help modernise the health service and develop a strengthened primary care sector. Negotiations are under way with the Irish Medical Organisation. The appropriate arrangements for phlebotomy services and to deal with differences of interpretation will be considered in this context. The process also provides an opportunity to ensure maximum clarity on the scope and nature of the service to be provided, including the taking of blood for diagnostic purposes or in connection with the treatment or monitoring of an ongoing condition. Notwithstanding these engagements, the contractual position is as outlined by the Deputy and the HSE has and will continue to take action where medical card or GP visit card patients are charged inappropriately.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I concur and believe it is quite clear and specific under the Health Act 1970, as amended, that GPs should not be charging general medical scheme card holders for blood tests. However, the evidence is not just anecdotal that we know that this is happening. This notification is now appearing-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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We do not display notices in the Chamber.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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----in general practices-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Is the Deputy listening to me?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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-----that reads very clearly, "Important notification". I will read it. It states that from 1 January 2016-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I have told the Deputy that he must not display notices in the Chamber. He is here long enough to know this.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I beg your pardon. I am reading it.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I beg the Deputy's pardon.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I am reading something as I am quite entitled to do. It has been a belligerent morning and most odd. The notice reads: "From January 1st 2016 it will be necessary to charge all patients who have medical cards a fee of €15 for blood tests".

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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We are over time.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I ask the Minister of State to note that this is now appearing in general practices as a notification of intent.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I call on the Minister of State to reply very quickly.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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It confirms what we know already.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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It was not the Deputy's fault, but we were ten minutes late starting.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for that information, but I, again, point out that 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 other expenses incurred by him or her for the use of any premises, equipment or instruments in making the service available. I will bring what the Deputy has outlined to the notice of the HSE once again.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I ask the Minister of State to note that I have highlighted the fact that there are a number of general practices which intend to make this policy as and from 1 January 20016, a short number of weeks away. It is imperative that we deal with the matter because we will see an escalation as a consequence of that statement of intent. The people who have to deal with it are the Minister and the Minister of State. It has to be made clear to all general practitioners that this is not allowable or acceptable.

Kathleen Lynch (Cork North Central, Labour)
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The contract is very clear and explicit. I will bring the information the Deputy has produced to the notice of the HSE and we will make sure it is acted on.