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Can tea tree oil get rid of headlice?

GPs are stepping up their

battle with ministers to allow informed dissent for MMR

after new figures showed uptake of the vaccine plummeting to a record low.

GPC negotiators branded Government policy 'hypocrisy' in the wake of annual Department of Health statistics showing a shock 2 per cent fall in coverage among two-year-olds in 2003/4.

In a further blow, latest quarterly data from the Health Protection Agency showed a drop of 0.4 per cent between April and June.

The news came as GPs reported the first crack in national policy, with a London primary care trust striking a local deal with PMS practices to allow them to exclude informed dissenters from target pay calculations.

Dr Karim Janmohamed, co-chair of Greenwich LMC, said his practice had been paid for 90 per cent uptake by Greenwich PCT, even though it 'was just about hitting 80 per cent' overall. 'Those of us who have gone PMS have had certain benefits,' he said.

GPC negotiator Dr Andrew Dearden said the new uptake figures put 'added emphasis' on the case for dropping target payments or allowing informed dissent.

'We have repeatedly told the department this is affecting people's decisions but they have not budged,' he said. 'They are all for patient choice but then all for GPs making patients agree to vaccination. It's hypocrisy.'

Despite three earlier sets of preliminary quarterly data showing increased MMR uptake across the UK, final updated figures for 2003/4 showed uptake in England fell to 80 per cent.

No PCO is hitting the World Health Organisation 95 per cent coverage target to prevent disease outbreaks.

Dr Natasha Crowcroft, consultant epidemiologist at the Health Protection Agency and head of the data programme, said a group of parents 'were not being convinced' of the safety of MMR despite strong evidence.

The agency blamed the

latest fall on media coverage

of research suggesting a link between thiomersal and autism, despite thiomersal being absent from MMR.

Uptake of first MMR vaccine by age five also fell by 0.5 per cent and coverage of the preschool booster plunged by 0.6 per cent in the last quarter.

Some 1,352 cases of mumps were reported between April and June ­ the highest in the seven years since records began.

By Emma Wilkinson

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