Galway GPs told not to refer patients for blood tests

Family doctors in Galway have been told by the laboratory manager at Galway University Hospitals not to refer patients for blood tests on the grounds that they do not provide a phlebotomy service for GPs.

In an email to GPs, lab manager and chief medical scientist Margaret Tarpey said there had been “several circumstances of late whereby patients have been forwarded from GP practices to the outpatients phlebotomy department to specifically have blood drawn for general laboratory tests”.

Ms Tarpey advises that: “The phlebotomy department is solely for patients attending hospital out-patient clinics and of course the patients within the hospital itself.”

She said they were “unable, unfortunately, to provide a phlebotomy service for GPs and have never done so in the past”.

The Galway University Hospitals group is comprised of University Hospital Galway and Merlin Park Hospital, which are part of the wider Saolta group.

However the Irish Medical Organisation (IMO) said that under section 56 of the Health Act 1970, hospitals are obliged to provide phlebotomy services to all patients.

“This was confirmed to us by the Ombudsman as far back as 2007 and reaffirmed by the then minister for health [James Reilly] in 2014,” the IMO said.

The IMO said this obligation extended to all citizens with either full or limited eligibility.

It said it was their position that phlebotomy “does not form part of the GMS contract”.

“Where GPs provide a service outside of the GMS contract the patient may choose to be referred to a public service, to which they are entitled as above, or may choose to avail of the service privately from the GP – this is a matter for the patient,” the IMO said.

A spokesperson for Saolta said in the majority of cases, phlebotomy is carried out in the GP’s surgery and the bloods are analysed at hospital labs.

“Some patients may choose to have their phlebotomy carried out in out-patient clinics and hospitals are legally obliged to provide this service,” the spokesperson said.

She said the phlebotomy department at Galway University Hospitals “continues to provide phlebotomy services to GPs” but that it had noted “increasing numbers of patients presenting to the department without any form of identification, referral letter or indication of what blood tests are required”.

The hospital has, therefore, requested that the referring GP practice provide the phlebotomy service with authorisation and indication of what blood tests are required.

“The phlebotomy team have not taken samples in the past without this and cannot do so,” the spokesperson said.

Once the patient had the appropriate documentation the hospital would provide them with the necessary phlebotomy service, she said.

The spokesperson said they would be in further contact with GPs to clarify this.