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Aggressive stroke prevention in the elderly 'not evidence based'

Inequality is a buzzword in the NHS these days, and new data on flu vaccination in the under-65s is the latest to be held up to scrutiny. It turns out some at-risk groups are more equal than others, with 61 per cent of diabetes patients receiving the flu vaccine, but just 31 per cent of those with chronic heart disease.

Another study finds ­ to no one's great surprise ­ that patients in deprived areas are also prone to missing out.

GPs will doubtless be castigated for unevenness of effort, but the fact is some groups are easy to reach, others far harder. Not all patients are as well programmed to the benefits of preventive medicine as those with diabetes. The bungled addition of new at-risk groups to this year's flu campaign will only make things worse.

The Government has so far neatly sidestepped the obvious solution. It is time to pay GPs extra money for vaccinating those patients who are hardest to reach ­ but who may benefit most.

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