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'Asthma patients need proactive care'

The Department of Health has a nice line whenever it is asked a difficult question about primary care. 'We're not taking a position on that,' it will respond. 'It's up to individual PCTs to decide.'

So it is up to individual PCTs whether to pay GPs for immunising new at-risk flu groups and up to individual PCTs whether to indemnify GPs for giving unlicensed MMR vaccines. A monumental act of buck-passing has been neatly dressed as devolution of power within the NHS.

While some PCTs are coughing up the flu cash or agreeing to provide indemnity on MMR, others are not, creating postcode lotteries galore. And with Government research laying open the strained relations between GPs and PCTs, it seems unlikely things are going to get better any time soon.

Ministers must recognise that leaving difficult decisions to PCTs produces only a patchwork of poor quality policy. GPs deserve to be treated better ­ but most of all, equally.

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