Sir, – Andrew Duggan draws attention to a very important issue; the confusion regarding charging for a Covid-19 test (Letters, August 27th). He tells us that the HSE informed him that any charge "is entirely at the GP's discretion".
In the context of overall Government policy to ensure that all citizens can access primary care services, such discretionary power to levy charges is extraordinary but is not without precedent.
In recent years, we have seen GPs employing that “discretion” to apply a charge for phlebotomy (blood test) services rather than providing the service under the GMS (medical card) scheme, as the Government wants and insists that it be covered under the current GP contract.
This situation, whereby GPs rather than the Government are being allowed to decide what healthcare services should be available free at the point of delivery, has been allowed to continue for some considerable time now, despite causing distress to patients, particularly the elderly who are living on low fixed incomes.
The fact is that successive Ministers for Health have sat idly by and allowed this situation to continue so the Government can hardly be surprised that some GPs might seek to extend such “discretion” to other services.
There is a real danger that, over time, the GMS scheme could be rendered totally ineffectual in achieving its objectives.
The solution to this problem is relatively simple. Government must take back full control of healthcare policy. To this end, serious consideration should be given to introducing the method of GP care provision used in the UK. There, GPs generally are employees of the NHS rather than private entities, as is the case here, and this ensures that government policy regarding healthcare provision remains entirely under the control of the government and minister for health. – Yours, etc,
JIM O’SULLIVAN,
Rathedmond,
Sligo.