HSE deducts money from GPs to repay patients

More than €8,000 has been refunded to medical-card patients after the Health Service Executive (HSE) ruled its GPs were wrongly charging them for blood tests.

The HSE deducted the money from payments to the GPs after investigating 121 complaints about charging for phlebotomy services in the past three years.

Two-thirds of the complaints originated in the southeast, according to figures provided to The Irish Times by the HSE.

There were six written complaints in the southeast in 2013, 42 in 2014 and 29 so far this year.

The HSE says it has deducted money from the fees it paid to 50 GPs since 2012. In that year, just one GP suffered a deduction of €40.

In 2013, five GPs had deductions totalling €1,700, while last year the total amount deducted rose to €7,285 in respect of 31 doctors.

Another €805 has been deducted so far this year in respect of 13 doctors, but this figure is likely to rise as more complaints are processed.

GPs, who have had their fee income drop in recent years, insist they are entitled to charge medical card patients for routine blood tests, such as when monitoring a condition.

According to the HSE, under the general medical services (GMS) scheme a doctor is expected to provide patients with medical cards or GP visit cards with “all proper and necessary treatment of a kind generally undertaken by a GP and not requiring special skill or experience of a degree or kind which GPs cannot reasonably be expected to possess”.

It says GPs cannot charge GMS patients when blood tests are required for diagnosis or for monitoring conditions.

However, the Irish Medical Organisation, which represents doctors, said it does not accept routine blood tests are covered by the GMS contract which is for "acute care".

It said the Department of Health is responsible for providing phlebotomy outpatient clinics in public hospitals and in these circumstances GPs advise patients a free public service is available for them.

“In some cases, GPs provide phlebotomy services as an additional service to patients [ie not covered by the GMS] and patients may choose to avail of this service in the GP surgery for which there may be a charge.”

Legal action

Another doctors’ organisation, the National Association of GPs, has said it will take legal action over the deductions from its members’ payments.

The HSE says any “ambiguity” in relation to charging will be addressed through correspondence with GPs and through changes to the GMS scheme. Talks on the new contract are expected to conclude by next March.

One woman took to social media to complain about being charged for blood tests: “As someone who suffers with thyroid problems I have to attend the doctors quite often to be monitored and have my bloods checked on a monthly basis.

“Was just in today for a check-up and look what I see. From January 1st I will now have to pay €15 every time I get my bloods checked.”