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." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for medical services provided under the contract.
It is a matter for the treating GP to determine in the case of each individual patient what is proper and necessary care. In circumstances where a GP, in the exercise of his/her clinical judgement, determines that a particular treatment or service requested by a patient is not clinically necessary, but the patient still wishes to receive same, it is at the GP's discretion whether he/she imposes a charge for providing the service/treatment in question.
Consultation fees charged by GPs outside the terms of the GMS contracts are a matter of private contract between the clinicians and their patients. My Department has no role in relation to such fees.
In line with the criteria under Section 3 of the Health (Pricing and Supply of Medical Goods) Act 2013, only products that are generally prescribed by a medical practitioner are on the HSE reimbursement list. Vitamins and minerals do not generally need a prescription. However, there is a limited range of products that were historically available on the GMS reimbursement list. Injectable Vitamin B 12 is one such product on the reimbursement list and, subject to the statutory prescription charge, is available to medical card holders without charge.