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Primary care will lead in N. Ireland

By Daniel Cressey

Tens of thousands of GPs are missing out on top-rate child vaccine pay after controversial changes to rules for calculating uptake.

Figures obtained by Pulse show the numbers eligible for higher vaccine target pay plummeting by up to 80 per cent.

GP leaders warned practices might opt out of vaccination services en masse after facing losses of thousands of pounds this year.

Dr George Kassianos, the RCGP immunisation spokes-man, said: 'There will be dire consequences, huge consequen-ces, and the department would have the biggest problem it's ever had on vaccination.'

Dr Andrew Dearden, GPC negotiator and a GP in Cardiff, said: 'If this isn't sorted my practice will seriously consider whether to [opt out].'

The average practice is set to lose more than £5,000 a year under the new rule. Since April uptake has been calculated on two vaccines rather than four, meaning practices with MMR uptake of 80 per cent would need 100 per cent uptake of the five-in-one to hit the top target.

In Kent LMC the proportion of practices receiving the higher pay rate for achieving 90 per cent uptake has dropped from 92 per cent to 16 per cent. Dr Mike Parks, chair of Kent LMC, said: 'The situation is abysmal and totally predictable.'

Wandsworth PCT told Pulse its proportion of practices hitting top pay had fallen from 46 to 28 per cent. And in Yorkshire 'uptake has not changed but achievement has changed significantly,' the GPC said.

Dr Hamish Meldrum, GPC chair, said: 'I now have figures to show there has been a significant fall of GPs hitting the higher targets. I am even more concerned it may mean incentives to immunise are diminished if there is no prospect of hitting the higher target.'

GPs reacted with fury to the losses as a row broke out between the Department of Health and the GPC over who was to blame for the fiasco.

Dr David Baker, vice-chair of Lincolnshire LMC, said: 'The GPC should never have agreed to such a change ­ I was flabbergasted they agreed.'

The department blamed the GPC for the mess, saying: 'We

offered to include Men C in a revised target scheme to compensate for the reduction in imm- unisation courses, but this was rejected.' Dr Meldrum denied receiving a 'formal offer' on Men C.

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