General Practitioners (GPs) provide services to medical card holders in Ireland free of charge. Those GPs in the Primary Care Re-imbursement Service (formerly known as the ‘GMS’) scheme enter into contracts with Health Service Executive (HSE) to provide services. Patients may generally choose their doctor from a panel of doctors who are part of the scheme, provided the doctor is willing to have them as patients. In general, services must be provided by your own doctor but there are arrangements for emergencies and for moving out of your area. Doctors must treat medical card patients in the same way as they treat private patients.
Choosing your doctor
When you apply to your Local Health Office for a medical card, you are given a list of doctors together with a Doctor’s Acceptance Form. You can then choose a doctor from the list and ask the doctor to sign the Acceptance Form, which is then returned to the Local Health Office. In general, you must choose a doctor whose surgery is within 7 miles of your home unless there is no doctor within that area.
It could happen that a doctor would be unwilling to take on a new patient. (For example, if he or she already has too many patients. In general, doctors are not supposed to have more than 2,000 PCRS patients). If you are unable to find a doctor who is willing to take you on as a patient and have had three GPs refuse you service, the Health Service Executive (HSE) will assign you to a doctor. The medical card shows your name, date of birth and Personal Public Service Number (PPSN), as well as the date your card expires, if your card is issued for a limited period. If you wish to change doctors, you must complete a Change of Doctor form (available from the Local Health Office) specifying the new doctor. Some medical cards are issued for a limited period and a review date is shown on the card. In general, that means that the Health Service Executive (HSE) will look again to see if you are still entitled to a card. It does not generally involve choosing a doctor again.
Services provided by GPs under the Primary Care Re-imbursement Service (PCRS)
The GP’s contract with the Health Service Executive (HSE) specifies the range of services that the doctor must provide for medical card holders. Broadly speaking, these services must be provided at the same level and on the same basis as services to the GP’s private patients. This means that, for example, surgery times must be the same for all patients, access to home visits must be the same, etc.
- Consultation services at the GP’s surgery or at your home as appropriate
- Proper and necessary treatment of a kind normally undertaken by a general practitioner – this is a matter of individual medical judgement but it also includes services such as immunisation and vaccination for children.
- Required medical certificates, e.g., for application for social welfare payments and for absence from work. The medical card covers the issue of the first and final medical certificate to explain work absence. Other medical certificates may have to be paid for but the Department of Social and Family Affairs makes a payment for medical certificates for application for social welfare payments.
- Prescriptions for drugs, medicines and appliances as required. In some cases, GPs must dispense the drugs and medicines. You are entitled to have this service if the GP has only one practice centre and it is three miles or more from the nearest retail pharmacist. Doctors who dispense drugs and medicines under these arrangements are sometimes called “dispensing doctors”. In some parts of the country, the doctor’s surgery is still known as the “dispensary” even if the doctor is not a dispensing doctor.
There are certain services that GPs are not obliged to provide free of charge, for example, eye tests for a driving licence or for life assurance.
GPs in the PCRS scheme are expected to provide or arrange for the provision of appropriate emergency services for their own medical card patients. Rota systems may exist to provide cross cover arrangements of other doctors in out-of-hours situations.
Moving to another area
If you move to a new Health Service Executive (HSE) Administrative Area, you must re-apply for a new medical card with a new doctor’s acceptance form. The existing medical card remains valid for three months. To avail of services during those three months, you should make arrangements with the Local Health Office in the new area.
How to apply
Apply to your Local Health Office for a medical card. They will give you a list of doctors who are part of the PCRS scheme.