Duncan Smith (Dublin Fingal, Labour)
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290. To ask the Minister for Health if a person should be charged for a B12 injection when they are in procession of a full medical card, the person in question is being charged €20; and if he will make a statement on the matter. [44302/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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Under the terms of the current GMS contract, GPs are required to provide eligible patients with ''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." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for medical services provided under the contract. 

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, in the exercise of his/her clinical judgement, 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 GPs discretion as to whether he/she imposes a charge for providing the service/treatment in question.

Consultation fees charged by GPs outside the terms of the GMS contracts are a matter of private contract between the clinicians and their patients. My Department has no role in relation to such fees.

Vitamins and minerals do not generally need a prescription. However, there is a limited range of products that were historically available on the GMS reimbursement list. Injectable Vitamin B 12 is one such product on the reimbursement  list and, subject to the statutory prescription charge, is available to medical card holders without charge.

Duncan Smith (Dublin Fingal, Labour)
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291. To ask the Minister for Health if a person should be charged for blood tests when they are in procession of a full medical card, the person in question is being charged €20; and if he will make a statement on the matter. [44303/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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There is no provision under the 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 which are required to either assist in the diagnosis of illness or the treatment of a condition. This has been advised to GPs by the HSE. Notwithstanding this, I am aware that some GPs are charging GMS patients for phlebotomy services in some circumstances.

The issue of GPs charging GMS patients for phlebotomy services is complex given the numerous reasons and circumstances under which blood tests are taken. My Department and the HSE discussed this issue previously with the relevant GP representative body.  However, it did not prove possible to achieve agreement that no charges for blood tests would be applied in any circumstances. It is intended to raise this issue again at an appropriate time. 

It should be noted that the GP chronic disease management programme which is being phased in, having commenced last year, will involve the ongoing monitoring of patients’ conditions and any blood tests required in this context will be covered by the fees payable for this care.  

The position remains that where a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of GMS patients, carry out an investigation into each complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by the GP.