Written answers

Tuesday, 5 April 2022

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Social Democrats)
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880. To ask the Minister for Health the consultative structures that exist within the HSE or his Department in relation to policy on medical cards and operation of the scheme; if recipients or representative groups of recipients or other stakeholders are routinely consulted on the operation of the medical card and general practitioner visit card schemes; the way in which this is carried out; the frequency with which this is carried out; the plans there are to establish dedicated consultation structures with relevant stakeholders; and if he will make a statement on the matter. [18333/22]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a Medical Card/General Practitioner Visit Card is determined by the Health Service Executive (HSE). Regarding the operation of this Scheme, I wish to assure the Deputy that officials in my Department engage with relevant stakeholders and representatives as part of its continued effort to provide for an effective and efficient scheme in accordance with the legislative framework provided for under the Act.

As this question also requests relevant information relating to the medical and GP Visit Card Scheme operated by the HSE, it has also been referred to the Health Service Executive for direct reply to the Deputy.

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Social Democrats)
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881. To ask the Minister for Health the circumstances under which a general practitioner may and may not charge respectively, a medical card holder who requests a letter to be written on their behalf for a health reason; the information or guidance that is available to medical card holders on the definition of appropriate charging in this respect; and the system that is in place to protect medical card holders against inappropriate charging. [18334/22]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The HSE reimburses GPs for services provided under the GMS contract to medical and GP visit card holders. Under the terms of the GMS contract, a medical certificate may be furnished to a person the medical practitioner has examined in relation to any illness noticed during the examination which is reasonably required.

Section 11 of 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.

Section 10.8.4 of the Under 6 contract stipulates that in providing the services, the Medical Practitioner shall furnish in relation to child patients whom he/she has examined and for whom he/she is providing services, a certificate in relation to any illness noticed during the examination which is reasonably required by the child patient’s parent(s)/guardian(s). Certain other certificates, such as insurance or assurance policies, school attendance notes/certificates are not covered by this contract. The scope of services under this contract does not include all services provided by General Practitioners. The following non-exhaustive list is indicative of some of the work which is not covered by the contract: passport / identity reports / letters, crèche reports, utilities reports / letters, insurance medicals / reports, school attendance notes / certificates, sports medicals / reports, medico-legal reports, drug kardexes for state or private institutions, certificates / letters in support of applications for services under the Social Welfare Acts, certain TUSLA related work such as pre-placement medical examinations / reports, fostering and adoption reports.

If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for 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.

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