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At the heart of general practice since 1960

Boycott urged on unpaid work

Dr Michael Duggan caused a local storm when he took drastic action to haul up his uptake rates for MMR.

Dr Duggan, who practises in Stevenage, wrote to eight MMR dissenters advising them they would be removed from his list because their decisions were 'adversely affecting' his pay.

Dr Duggan, a busy single-hander with 4,200 patients, admitted he had been tired and frustrated when he wrote the letters, but said he had been motivated primarily by concern for his patients.

'We had a case recently of a student who had mumps and is now sterile,' he said. 'There are innocent children who are not being vaccinated and there are outbreaks going on so the Government's strategy isn't working.'

Dr Duggan said it had been the first time he had missed out on the 90 per cent uptake target. 'It was very frustrating that we put in a lot of work and gave our professional opinion and it didn't make any difference. It's ludicrous that the Government is holding us responsible.'

News of the letters hit the local press and North Herts and Stevenage PCT stepped in to insist the patients could not be removed. Dr Duggan has since apologised to them, but he said the upshot had been largely positive.

'I've had huge support from other patients, lots of letters and cards,' he said. 'One guy said to me ''you shouldn't be so honest, doctor''.'

Four of the MMR dissenters have now agreed to let their children have the vaccine, although three more have left the practice.

Dr Duggan said the GPC had let the profession down by not pressing harder for exception reporting for all childhood vaccines in the new contract. 'There was a clear mandate and they didn't agree it. Maybe the Government feels herd immunity is more important but to penalise us is wrong. The whole target system is wrong.'

GPC negotiator Dr Andrew Dearden said: 'I understand the financial pressure but in terms of the doctor-patient relationship it's not an approach I can support.'

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