Disarray over plans to immunise under-fives
The government's plans to offer a swine flu vaccine to all children aged between six months and under five appear in disarray after a deal with family doctors broke down.
The British Medical Association, which represents GPs across the UK has refused to sign up to the plan which would have seen family doctors offering the jab to more than three million children.
Neither the Department of Health nor the BMA has revealed why an agreement with the GPs was not possible. GPs are still immunising priority at-risk groups - those with existing health conditions and pregnant women. Doctors get £5.25 for each person immunised.
One source said the payment per vaccination was not what scuppered a deal, but that it collapsed because GPs wanted flexibility over government targets for patients booking general appointments during the swine flu immunisation campaign.
Doctors get incentive payments for a variety of targets - including those for offering an appointment within 48 hours and booking ahead.
The source said GPs were given lee-way as a result of the extra pressure of work involved in vaccinating the initial priority groups, but the same flexibility was not being offered with young children.
Nonetheless the Health Secretary, Andy Burnham has said that immunisation for under-fives will start in the run up to Christmas.
Young children are being recommended to have the swine flu vaccine because they are the most likely group to catch flu, and the most likely to require hospital treatment.
So if you are a parent with children under five, who will immunise your child? It's really not clear at all. According to the Department of Health it's now up to Primary Care Trusts to organise it.
You might get an invitation from your GP if they can be persuaded to do it, or it might involve a trip to hospital, to a pharmacy, a health clinic or you might get a visit from a health visitor or district nurse. Clear, simple and straightforward it is not.
The Department of Health said:
"We hope many GPs will still decide to vaccinate under-fives. But where GP practices do not wish to vaccinate this group, PCTs will determine whether vaccinations will be offered through other local GP practices, their directly managed staff (eg health visitors, district nurses etc) or by arranging with alternative providers (eg community or hospital paediatric services, pharmacies etc). Parents of children in the priority group will receive information about swine flu vaccinations as soon as these plans have been finalised."
But Obi Amadi from the Health Visitors' Association said:
"I'd be very concerned because we haven't got enough health visitors to the basics of working with families under five. So this is going to be another thing we are expected to juggle. We are going to be spread even more thin."