Explanation of blood test charges @ Corbally Medical
Under the GMS (medical card) contract, a GP is obliged to ensure that necessary investigations are undertaken in relation to diagnosing a patient's condition. This would include diagnostic blood tests. This can be done through the GP arranging for the patient to attend a HSE outpatient phlebotomy department as per the Health Act. Alternatively, the GP can choose to undertake such blood tests during the consultation but the GP is not obliged under the GMS contract to take any blood tests. Should a GP choose to take a diagnostic blood test relating to a particular presentation (e.g. a blood sugar test to diagnose if someone is presenting with diabetes) it is not normal practice to charge the GMS patient for ethical reasons because that patient is by definition unwell and therefore in a compromised position.
On the other hand, the HSE is obliged to provide free blood tests under the Health Act for all citizens of the State - GMS and "private" patients. This has been confirmed by the Ombudsman. The Health Act determines what services the HSE provide. The Health Act does not apply to GPs.
Should a GP choose to provide a phlebotomy service within the practice – which again is not a contractual obligation under the GMS contract– blood tests that are not diagnostic in nature are normally chargeable for all patients. These could include blood tests relating to health screening, chronic disease management, drug monitoring, routine medicals, hospital and consultant requests for phlebotomy etc.
Many politicians and others do not understand that GPs have no obligations arising from the Health Act. The HSE carries all such obligations. GPs are then contracted by the HSE to carry out certain health care functions on behalf of the HSE through the GMS and other contracts (e.g. Mother and Infant scheme / Childhood immunization scheme contracts etc.). These contracts do not include the provision of a phlebotomy service with the exception of certain blood tests as part of "Chronic Disease Management" programmes that have recently been introduced.
All patients - both GMS and "private" patients - are entitled to attend a HSE phlebotomy ("blood test") clinic free of charge. It is every patient's choice whether they pay the GP clinic for a phlebotomy service or attend the HSE service. Each time you are due to have a blood test you should let the clinic know which service you would prefer and we would be pleased to arrange either service for you.