Dáil Éireann Debate, Thursday - 21 September 2023
258. Deputy Michael Healy-Rae asked the Minister for Health if he will review hidden healthcare costs by ensuring all medical needs are covered by the medical card and ensuring speedy access to mental health services; and if he will make a statement on the matter. [40820/23]
View answerIt is understood in regard to hidden health costs that the Deputy is referring to instances of GPs charging medical card holders for certain services, namely obtaining certain documents and for blood tests.
GP services are provided free of charge to people who hold a medical card or GP visit card. 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."
The issue of GPs charging GMS patients for phlebotomy services (blood tests) is complex given the numerous reasons and circumstances under which blood tests are taken. Clinical determinations as to whether a blood test should taken to either assist in the diagnosis of illness or the treatment of a condition are made by the GP concerned. There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for such blood tests. In addition, blood tests undertaken in the context of services provided under the GP Chronic Disease Management Programme are covered by the fees paid to GPs by the HSE for this care.
The issue has been raised previously with the relevant GP representative body. However, it did not prove possible to achieve agreement that no charges for blood tests would be applied in any circumstances.
Where 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, or has been charged for a blood test provided under the Chronic Disease Management Programme, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of GMS patients, contact the GP concerned and carry out an investigation into each complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by the GP.
The GMS contract stipulates that fees for medical and GP visit card holders are not paid to GPs 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".
Any fees charged by GPs for services provided outside the terms of the GMS contract are a matter of private contract between the GP and their patients. The HSE does not have any role in relation to such fees.
Core objectives of our national mental health policy, Sharing the Vision 2020-30, and of the HSE Service Plan 2023 is to improve access to mental health care for all the population. A range of mental health supports are available to persons experiencing mental health difficulties, including supports provided by the HSE, HSE-funded organisations, counselling services, helplines and online supports. Information on mental health supports is available through the HSE website and the HSE Your Mental Health Information Line. GPs can provide support to patients experiencing mental health difficulties and can arrange for referrals to mental health services in the community or specialised services.
