Delay threat to swine flu jab for under-fives

Published on Tuesday 8 December 2009 21:44

THE swine flu vaccination programme for young children could be hit by delays and confusion after government officials failed to reach an agreement with doctors to deliver the jab, experts warned last night.

The deadlock in negotiations between doctors and the four UK administrations means health boards in Scotland will have to come up with their own local arrangements to provide the vaccines, possibly involving district nurses and health visitors.

Concerns were raised yesterday that this could lead to a "postcode lottery" of provision across Scotland.

Doctors said they had not asked for more money to give the vaccine – but wanted extra flexibility over meeting targets and support to cope with the extra workload.

GPs across the UK are currently vaccinating at-risk groups, including pregnant women and those with chronic health problems.

The next phase of the campaign will see the H1N1 vaccine offered to healthy children aged six months to five years. Children in this age group are at greater risk of catching flu and are also more likely to need hospital treatment.

Under the first phase of the programme, a UK-wide deal was struck with GPs to give the jab for 5.25 per dose. But negotiations for the second phase of the campaign have broken down without agreement.

It is believed that GPs wanted extra concessions and flexibility over the rest of their workload to help them to vaccinate a large number of healthy children.

Dean Marshall, chairman of the BMA's Scottish GPs committee, said that, under the deal for the first phase of the vaccination campaign, there were concessions on the target for doctors seeing patients within 48 hours – a target linked to the funding practices get for providing their services.

Dr Marshall said they were also given extra help, such as support from district nurses.

But he said that, for the second phase, no such concessions had been agreed, or any more leeway given in the 48-hour requirement.

"If I am being monitored on access, then my access isn't going to be as good if I have got an extra 700 appointments for children," Dr Marshall said.

"So it wasn't about us doing it or not. It wasn't about more money. It was about how we were going to fit that in, in addition to everything else we are doing at the busiest time of the year.

"It seems slightly unfair to be monitored on access, which could result in defunding my practice, at a time when I am prioritising access for children."

Health secretary Nicola Sturgeon said that, while she was

disappointed that a deal could not be struck, boards would be given funding to make their own arrangements.

These arrangements, she said, would be likely to involve GPs, in deals struck locally with health boards, as well as public health staff being used to give the jabs.

Yesterday, the Scottish Government said it was on track to complete the first phase of the campaign covering at-risk groups by Christmas.

It said that children would begin to be invited for jabs before the Christmas break, with the programme continuing throughout January.

However, Labour spokeswoman for health, Jackie Baillie, said: "I am concerned that the failure to reach an agreement with GPs will lead to a postcode lottery in the delivery of the flu vaccination programme.

"The health secretary is responsible for delivering the programme in an efficient way. There is already evidence that people in priority groups do not have access to the vaccine in some parts of Scotland."

The Tory health spokeswoman, Mary Scanlon, said: "Patients rightly look to government and to the BMA to ensure the systems and payments are in place to give every priority group the vaccinations they need.

"Patients expect co-ordination and co-operation, not confusion," she said.

Margaret Watt, chairwoman of the Scotland Patients' Association, said she was concerned about the failure to reach a deal. "It is very sad that children like that should be held to ransom," she said.

"It is shocking. The children are caught in the middle of this, and these people should be ashamed of themselves."

Ms Watt said she was concerned about possible delays in the vaccination programme and called on doctors to reach a deal to give the vaccine.

"Swine flu is not going to hold back until their negotiations are finished," she said.

"Doctors have a lot of power, and they should not have the power to put our children's lives at risk."

In a letter to doctors, the BMA's UK GP leaders said practices were currently working hard to deliver the first wave of vaccinations.

"We also know from listening to GP representatives across the UK that many practices are struggling to cope with the combined effects of normal seasonal illness, flu-related workload and the vaccination campaign," they said.

"It was with this in mind that we had to insist that any national agreement for phase two of the campaign supported practices by releasing staff time and covering additional costs.

"Unfortunately, the health departments were unwilling to agree sufficient measures to help free up practice time to support this programme."

The BMA said an average practice might have about 360 patients under five and would need to offer enough appointments to cover this group.

It said those appointments would be longer, "because of the extra time needed to provide explanation and reassurance to parents and children".