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. The contract between the HSE and GPs under the GMS Scheme stipulates that fees are not paid to GPs by the HSE 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". Consultation fees charged by general practitioners to private patients and to GMS patients outside the terms of the GMS contract are a matter of private contract between the clinicians and the patients. While I have no role in relation to such fees, I would expect clinicians to have regard to the overall economic situation in setting their fees.