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At the heart of general practice since 1960

Ageism ­ or a blow for sanity?

GPs face having to immunise large numbers of patients against influenza for free after PCTs warned there was no money left to fund local enhanced services.

The Government last week announced it was expanding the flu campaign to cover patients with chronic liver disease and carers of elderly and disabled people ­ but said funding for GP payments must come from local enhanced services.

But PCTs have told Pulse their enhanced services budgets are already spent and that other services could suffer if money was diverted to the new priority.

GPs are concerned that even if they can get assurances over enhanced services funding, there will be insufficient time to negotiate local enhanced services before the campaign begins in October.

Dr George Kassianos, chair of Bracknell Forest PCT's professional executive committee, said: 'PCTs have no funds to organise these additional requests. Any new requests and additions to the at-risk groups by the Department of Health must be financed centrally and exclusively.'

He added that it was not too late for the new campaign to kick off on time in October but only if funding wrangles were sorted out.

Durham Dales PCT said: 'The money has all been spent. It is just putting more pressure on our stretched budgets.'

Dr Nigel Watson, chief executive of Wessex LMCs, said: 'All our PCTs are overspent. They have virtually all reached the enhanced service floor and have no spare cash.'

GPs said they believed the Government had given them such short notice in the hope they would be pressured into vaccinating patients for free.

Dr Watson said: 'GPs will have the right to say no but they will end up doing it. The cynical view is that the Department of Health has done this so it doesn't have to pay up.'

But Dr Bob Morley, joint chief executive of Birmingham LMC, said GPs should feel no obligation to vaccinate target groups if negotiations failed.

'It's very disappointing that the Government should unilaterally impose extra work without negotiation,' he said.

GPC chair Dr Hamish Meldrum said he had written to the Department of Health and was awaiting its response.

By Rob Finch

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