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Last-ditch fudge agreed on childhood vaccinations

The GPC fought until 'the last minute' to ensure GPs who fail to hit 90 per cent uptake for childhood vaccinations will not face financial penalties.

Under a complex compromise thrashed out with the Government, all practices will be expected to achieve at least 70 per cent uptake as an additional service funded within the global sum. Practices will only be able to opt out in

'exceptional circumstances'.

Above 70 per cent uptake, vaccinations become a directed enhanced service commissioned by the primary care organisation, allowing GPs to opt out ­ although it is unclear how this could work in practice.

GP negotiators lost the battle for informed dissent to apply to childhood vaccinations, but they forced the Department of Health to limit the mandatory element to immunisations below 70 per cent uptake.

GPs will continue to receive an additional target payment for hitting 70 per cent coverage. But practices that fall short will have a portion of their global sum clawed back as a penalty ­ £1,059 in 2004/5 for an average GP with 1,800 patients.

There will be a further target payment for hitting 90 per cent uptake, although the cash figures had not been revealed as Pulse went to press.

GPC negotiator Dr Andrew Dearden said GP leaders had managed to negotiate a compromise on the 90 per cent target but the Government had refused to shift on keeping the 70 per cent threshold under additional services.

'What we did at the last minute was make sure we had the greatest possible security with respect to GPs' income.

'At the moment you're not getting anything upfront at all. With the new contract you're getting an infrastructure payment upfront to help you get to 70 per cent,' he said.

There will be no additional infrastructure money to help practices striving for 90 per cent coverage.

Fellow negotiator Dr Laurence Buckman said the penalty for practices that failed to get 70 per cent uptake remained a matter of dispute. 'The Chief Medical Officer says he will review the situation,' he added.

RCGP immunisation spok-esman Dr George Kassianos said keeping the target system was unfair. 'The Government thinks if it were to relax the rules about MMR that GPs will relax. I think they're wrong,' said Dr Kassianos, a GP in Bracknell, Berkshire.

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