Jack Wall (Kildare South, Labour)
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To ask the Minister for Health the position regarding a payment for medical services; if he has had any meetings with the representative bodies regarding same; if any progress has been made to resolve this issue; and if he will make a statement on the matter. [14806/13]

Alex White (Dublin South, Labour)
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The current General Medical Services (GMS) General Practitioner (GP) Capitation Contract was introduced in 1989 and is based on a diagnosis and treatment model. Section 11 of the current contract states as follows:

"The medical practitioner shall provide for eligible persons, on behalf of the relevant Health Board, all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess. This will include such preventive and developmental services as are currently provided or may be developed in the new style of practice which this agreement facilitates, some of which services may be included on the list of special items of service for which specific payments shall be made. "

In circumstances where the taking of blood is necessary to either (a) assist in the process of diagnosing a patient or (b) monitor a diagnosed condition, General Practitioners (GPs) may not charge patients if they are eligible for free GMS services under the Health Act, 1970, as amended.  It is the contracted responsibility of GPs to provide proper and necessary treatment to eligible persons. If part of that proper and necessary treatment includes routine phlebotomy, GPs must provide such services free of charge under the terms of their General Medical Services (GMS) contract.

The HSE has written to GP contract holders and clarified the position in relation to phlebotomy services and has also communicated its position to the Irish Medical Organisation. The HSE is also continuing to advise eligible patients who believe they have been inappropriately charged by a GP for routine phlebotomy services, to seek a refund from the GP in question.

The monitoring and appropriate care of patients receiving anti-coagulation therapy with Warfarin comes within the scope of competence of general practice. Warfarin testing is also available free of charge in hospitals. Warfarin testing is carried out by some general practitioners as a matter of course in their practices and I welcome this. This provides their patients with an option of receiving this service locally in a primary care setting rather than attending an acute hospital for this service.

The Programme for Government provides for the introduction of a new GMS GP contract with an increased emphasis on the management of chronic conditions, such as diabetes and cardiovascular conditions. It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams.

Officials in my Department are in consultation with the HSE with a view to drawing up a new contract. I have recently had discussions with the IMO during which I outlined the Government's policy in relation to free GP care and I intend to engage in further discussions with the IMO once that legislation is published. The appropriate arrangements in relation to phlebotomy services and anti-coagulation therapy will be considered as part of the new GMS contract.