The Irish Medical Organisation (IMO) has advised GPs that “routine blood tests, Warfarin monitoring, 24-hour blood pressure monitoring, and women’s and men’s health clinics”, once provided free to medical card holders, are not covered under GPs’ General Medical Services (GMS) contract with the Health Service Executive.
The IMO have instructed that it is up to GPs “whether they wish to charge or how they wish to charge ... If a GP decides to charge, it’s important that the patient is made aware that these services are available free from a hospital”
The HSE say: “The routine taking of blood samples from patients forms part of the normal and necessary treatment of patients undertaken by a GP and as such would normally be covered under the Medical Card Scheme, meaning that the card holder should not be charged”
An estimated 1.85 million people have the GMS card this year. Payments to GPs for the scheme are made through a wide range of fees and payments - as many as 50 different capitation rates apply based on age, gender, and 'distance from the surgery' (up to a maximum of €896.07 for persons aged 70 and over residing in a private nursing home) and more than seven additional payments (including a practice nurse allowance). The complexity of the system is such that nobody in the HSE or Department of Health can calculate an average cost figure. This answer to a Dail question on the issue five months ago makes interesting reading - it is suggested that average cost figures were not useful for policy; no alternative measure was suggested. The total cost of the GMS scheme this year is estimated at €2bn.