Under the General Medical Services (GMS) contract, a general practitioner (GP) is expected to provide his/her patients who hold a medical card or GP visit card with all proper and necessary treatment of a kind generally undertaken by a GP. Where blood tests form part of the investigation and necessary treatment of patients' symptoms or conditions, these should be provided free of charge to medical card and GP visit card holders. The HSE also points out that, in many GP surgeries, it is the practice nurse who takes blood samples. The HSE significantly subsidises the cost of employing practice nurses. The GMS contract does not make provision for charging medical card or GP visit card patients an administrative fee for phlebotomy services. The HSE is continuing to advise eligible patients who believe they have been inappropriately charged by a GP for routine phlebotomy services to seek a refund from the GP in question. It is appreciated that because of the nature of the GP-patient relationship, it may be difficult for patients to make such complaints. Where public representatives are made aware of GPs charging GMS patients in error, they may wish to notify the HSE directly.