Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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195. To ask the Minister for Health if medical card holders should be charged for tests (details supplied); and if he will make a statement on the matter. [15235/22]

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". Persons who hold a medical card or a GP visit card are not subject to any co-payments or other charges in respect of such services including GP consultations.

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 (blood tests) 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.

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 involves the ongoing monitoring of a patients’ condition and any blood tests 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 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.

However, the GMS contract stipulates that fees in respect of certain medical certificates which may be required, for example, "under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licences" are not covered by the contract. Any fees charged by GPs for services provided outside the terms of the GMS contract are a matter of private contract between the GP and their patient.