GPs are ignoring HSE advice not to charge Medical Card holders for blood tests 

Paul lives in Tipperary. He has a full Medical Card. He visits his GP and is told that he needs to have bloods taken in order to assist in the diagnosis of a possible condition. He is charged €25 for the blood work.

Mary lives in the same town as Paul. She too has a full Medical Card and visits her GP at a different practice but for the exact same reason. Happily, for Mary, her GP does not charge a fee.

This kind of scenario has been happening in every county in Ireland for the better part of 15 years, at least.

It is one of the routine issues that leads many people to contact their local TD. It is also profoundly unfair and possibly illegal in some instances.

Yet the practice of charging Medical Card holders for routine blood tests continues unabated and there seems to be nothing that either the HSE or the Minister for Health can really do about it happening.

You can go back a decade and more on the Dáil or Seanad record, and you will see an almost identical reply being given each and every time the issue is raised on behalf of an irate constituent.

The Oireachtas Member comes in, ask for an explanation in the discrepancy of treatment with respect to costs, and the Minister of the day will stand up and inform them that under the terms of the current General Medical Services (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.”

One recent Minister for Health even went so far as to say that “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 (blood work) services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition.”

For its part, the HSE has clearly advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card.

But just a few short weeks ago, a Minister of State at the Department of Health had to concede that, notwithstanding this explicit guidance, “I am aware that some GPs are charging GMS patients for phlebotomy services in some circumstances.”

He went on to say that this has been a “matter of concern” for successive Governments, who have made it known to GP’s that “no user charges should apply to GP services provided to GMS and GP visit card patients.

GP’s have fought back saying that the issue is far more complex and that it can be difficult to distinguish between routine and non-routine blood works.

This, as even the Ceann Comhairle himself recently said when the issue was raised for the umpteenth time, is nothing short of an “unadulterated fudge.”

So, what happens if a medical Card patient wants to complain about being unfairly charged?

Well, as the Dáil is so often informed, if 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.

Will this do any good? More than likely it will, even if the process is tedious and unnecessarily complex. That being said it may also lead to some embarrassing or uncomfortable silences the next time you visit your GP!

One TD, for instance recently submitted a parliamentary question on the numbers seeking such refunds after they complained about being incorrectly charged.
The Deputy was informed by the HSE that seven refund applications were made last year, and seven refunds were issued.

It remains deeply unfortunate however that people of limited means have to go to such lengths to get back the very money that they were never under any obligation to hand over in the first place.

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