The current GMS capitation contract is based on a contract agreement first introduced in 1989. It sets out the duties and obligations of the contracted registered medical practitioner in broad terms. While the contract would not have envisaged the deployment of 24 hour blood pressure (BP) monitoring technology as a standard feature of the range of services available in the primary care setting, it did become more commonly available in the years subsequent to the introduction of the capitation contract. Some GPs did not charge for supplying a 24 hour BP monitor to medical card patients whilst others charged a fee of €40-€50. In comparison, the charge for BP monitoring in one of Dublin's private hospitals is €165.
Consultation fees charged by general practitioners 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.
A Memorandum of Understanding signed in February 2015 commits the Department of Health, the HSE and the IMO to substantive negotiations on a new comprehensive GP contract commencing no later than 31 March with a view to concluding within 12 months. A priority of these discussions, which have commenced, will be the inclusion of chronic disease management for patients. The appropriate arrangements in relation to services such as phlebotomy or blood pressure monitoring will also be considered as part of these discussions.