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The Department of Health forced the GPC's hand on the new rule change after threatening a range of 'significant changes' to vaccine pay, it emerged this week.

In negotiations running from January to March, the department claimed the changes were justified because introduction of the five-in-one vaccine had reduced GP workload.

The department offered the GPC the chance to keep vaccine pay at current levels if it included meningitis C in calculations for vaccine uptake.

But the GPC refused, and claimed it was left with little option but to accept the change to uptake calculations.

Dr Hamish Meldrum, GPC chair, said: 'It was not possible to defeat the proposal for the calculation of the target payments.'

But he pledged to step up the fight for informed dissent for childhood immunisation to soften the blow of the rule change.

He promised the issue would be top of the agenda at a meeting with the Chief Medical Officer scheduled for the day after the general election.

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