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.
GPs are reimbursed by the HSE for medical services provided to medical card or GP visit card holders, while patients who do not hold a medical card or GP visit card access GP services on a private basis. I have no role in relation to the fees charged by individual GPs for services to private patients as they are a matter of private contract between the clinician and their patient.
Currently, the HSE operate two schemes which offer financial assistance to people in receipt of prescribed HRT medication on the reimbursement list. HRT medications on the reimbursement list are available without cost to medical card holders, subject to the statutory prescription charge. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card under the GMS scheme is determined by the HSE. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. Furthermore, under the Drug Payment Scheme, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines, which includes certain HRT medications.
Progressing women’s health is a priority for this government. Among the initiatives undertaken for the improvement of women’s health services is the development of six specialist menopause clinics. While the majority of women who seek support for their menopause can be effectively supported by their GP, a proportion of symptomatic women will require specialist medical expertise in menopause; it is intended these more complex cases can be dealt with, upon referral by their GP, in a specialist menopause clinic.
Two specialist clinics have been opened with a third opening this week. It is anticipated that the last three clinics in Cork, Dublin and Galway will open before the end of this year, which will result in a total of six such clinics nationwide, one in each maternity network, for women who require complex, specialist care.
In addition, the HSE’s National Women & Infants Health Programme are in the process of establishing a Professional Menopause Network which will comprise the clinical leads in this area from across the region and will include representation from the Irish College of General Practitioners (ICGP). The purpose of this network is to promote standardised care for women accessing the specialist clinics, but also to allow health professionals to learn from one another particularly in the implementation phase. It is also intended that clinical teams within the specialist menopause clinic setting will provide advice and guidance to GPs in the community to support the effective management of menopausal symptoms for women closer to home within primary care.
