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Independents' Day

Swine flu row has the profession on edge

The breakdown of talks over vaccination of under-fives has left GP leaders nervous that they will be seen as playing politics with children

By Richard Hoey

The breakdown of talks over vaccination of under-fives has left GP leaders nervous that they will be seen as playing politics with children

We had been preening ourselves on the Pulse editorial team this week after revealing details of the Government's proposals for next year's GP pay deal.

But as often happens when you think you've had a decent stab at setting the general practice news agenda, along came another story out of the blue to grab centre stage.

The breakdown of talks between the GPC and NHS Employers on swine flu vaccination for under-fives has fired off a fierce debate within the profession.

No one particularly argues with the GPC's figures, which suggest that the deal on the table would not have been cost-effective for many practices.

Nor do many GPs dispute the assessment of GPC negotiator Dr Peter Holden that practices are ‘at their limits' and do not have ‘infinitely expandable' capacity.

But a considerable number of GPs do take issue with the GPC's decision to choose this as a battleground issue with the Department of Health.

As one GP commented on our website: ‘We must choose our battles wisely. I for one am not happy to shield behind an under-five!'

And there's clearly a great deal of sensitivity within the profession's leadership on this one, as criticism we've received on one of our stories makes clear.

The GPC suggested LMCs should try to strike local deals on swine flu vaccination for the under-fives, presumably on the basis that PCTs might be more willing to offer the concessions it had sought on access targets than the DH had been.

So when Londonwide LMCs signed a deal that was almost identical to the national deal that the GPC had rejected, and with no concessions on access, Pulse reported it as having ‘broken ranks' with the GPC.

And it's fair to say that this interpretation has not gone down well.

Dr Michelle Drage, joint chief executive of Londonwide LMCs and a recent Pulse guest editor, vented her feelings on our website, criticising our story as ‘sensationalist' and insisting there had been no intention to ‘undermine' the GPC.

I'm sure that's the case, but I'm sure also that GP leaders are more than usually edgy about being seen to be divided.

Differences of opinion within the profession could, after all, be exploited to put the heat on the GPC for not signing up to the national deal.

So far, negotiators have got off pretty lightly, largely because the national media are losing interest in swine flu. It's not a mass killer – for most of us, it's not even a nasty cold.

But in the unlikely event that swine flu did surge again this winter, and claimed a significant number of lives among young children, the GPC's decision could be thrown back in its face.

This is a calculated risk, and one the negotiators will probably get away with. But it's easy to see why everybody is on edge.

By Richard Hoey, Pulse editor

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