Brendan Smith (Cavan-Monaghan, Fianna Fail)
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338. To ask the Minister for Health if medical card holders are entitled to have the costs of blood tests covered under the GMS; and if he will make a statement on the matter. [25969/24]

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.

Clinical determinations as to whether a blood test should be taken to either assist in the diagnosis of illness or the treatment of a condition are made by the GP concerned. There is no provision under the GMS GP contract for persons who hold a medical card or a GP visit card to be charged for clinically necessary blood tests.

In addition, blood tests undertaken in the context of the GP Chronic Disease Management programme are covered by the fees paid to GPs by the HSE 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 (i.e. a blood test to either assist in the diagnosis of illness or the treatment of a condition) by his or her GP, or has been charged for a blood test provided under the Chronic Disease Management programme, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of a GMS patient, shall contact the GP concerned and carry out an investigation into the complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by that GP.

Fees charged by GPs outside the terms of the GMS contracts are a matter of private contract between the clinicians and their patients. The HSE does not have any role in relation to such fees.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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339. To ask the Minister for Health if the costs of blood pressure/cardiac monitoring are covered for medical card holders; and if he will make a statement on the matter. [25970/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and their family can qualify for a medical card, while those for whom arranging GP services would be unduly burdensome can qualify for a GP visit card.

Medical card holders can currently access a range of services including general practitioner services, prescribed drugs and medicines, public in-patient hospital services, public out-patient hospital services, dental, ophthalmic and aural services. The GP visit card provides for GP services without charge. Certain groups, including all those under 8 years of age and those over 70 years of age, are automatically entitled to a GP visit card.

GP services to medical card and GP visit card holders are provided through the General Medical Services (GMS) scheme. Under the terms of the current GMS contract, GPs who hold a GMS contract 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.

The GP Chronic Disease Management (CDM) Programme commenced in 2020 and is available to adult GMS patients, medical card and GP visit card holders. The specified chronic conditions included in the CDM Treatment Programme are Type 2 Diabetes; Asthma; Chronic Obstructive Pulmonary Disease (COPD) and Cardiovascular Disease (including Heart Failure, Ischaemic Heart Disease, Cerebrovascular Disease (Stroke/Transient Ischemic Attack (TIA), Atrial Fibrillation). In addition, the Opportunistic Case Finding Programme identifies those at high risk of cardiovascular disease or diabetes for entry to the Preventive Programme and those with undiagnosed chronic disease(s) are enrolled under the Treatment Programme. Clinically appropriate examinations, including blood pressure monitoring, are included as part of the care reviews provided under the CDM programme. The CDM Preventative Programme was expanded to include hypertension from the 30th of November last year.

Furthermore, a special item of service fee is payable to GPs under the GMS contract for the provision of 24-hour Ambulatory Blood Pressure Monitoring for diagnosis and treatment of hypertension.

The Health (Amendment) Act 2023 removes the acute public in-patient charge for people accessing care as a public patient in public hospitals. This measure came into effect from 17 April 2023.

In addition, the Health (Out-Patient Charges) Regulations 2019 provides that, subject to certain exemptions, a charge shall be made for out-patient services provided at designated centres including an emergency department (€100) and a minor injury unit (€75). These exemptions include a person with a medical card, a person who has a letter of referral from a registered medical practitioner and a person whose attendance results in admission as an in-patient. Where care is provided in the public hospital system in an outpatient setting (other than services provided in certain designated centres including an Emergency Department or Minor Injury Unit) no charge is liable for persons attending as a public patient.