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The GPC is urging GPs to boycott all unpaid vaccination work after the Government refused demands to negotiate a national deal on public health.

GPs should turn down any request to give a vaccine that is not covered by an enhanced service and direct patients to their PCT to register their anger, the GPC said.

It believes the bullish approach is the only way to force the Government to introduce a directed enhanced service to cover all public health campaigns.

The current surge in mumps has exposed a 'postcode lottery' in GP payments for vaccination. Some GPs are being paid for vaccinating teenagers with MMR through local enhanced services, but others say they are doing it 'out of the goodness of our hearts'.

There are numerous examples of GPs in one PCT receiving payment but not their colleagues next door.

In Wales GPs in Rhondda Cynon Taff and Merthyr Tydfil health boards are paid £7.28 per vaccine but neither Cardiff nor Vale of Glamorgan has set up an enhanced service.

In Stockport GPs are paid through a generic local enhanced service for public health, but in neighbouring Manchester they are having to vaccinate patients for free.

Dr Tracey Vell, vice-chair of Manchester LMC, said: 'There is no enhanced service set up here. Our PCTs seem to spend more on secondary care, so we currently immunise students out of the goodness of our hearts.'

GPC negotiator Dr Andrew Dearden condemned the Government's policy of allowing PCOs to decide on vaccination policy locally. He accused ministers of 'devaluing public health' and insisted a boycott was the only answer. 'I'd give the number of the PCO to the patient so it can tell them why it is not going to pay.' he said. 'PCOs are taking a gamble that GPs will do it for free.

'It's the Government that's put us in this situation and it makes me wonder what the chief medical officers are doing. Until they change this "we don't tell PCOs what to do" nonsense you're never going to have an effective public health policy.'

GPs who are receiving money through enhanced services argue they are being underpaid by 40 per cent as item-of-service fees underestimate workload and resources involved.

The Department of Health said vaccination policy was kept under 'regular review'.

By Emma Wilkinson

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