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Patricia Hewitt, the Health Secretary, said that GPs had ordered too little vaccine, or had given jabs to the “worried well”, patients who were not over 65 or in the high-risk group, creating a shortage.
Doctors responded angrily. Dr Richard Vautrey, a Leeds GP who is a member of the British Medical Association GPs Committee, said that the claims were ridiculous.
“I don’t think it is fair to blame GPs” he said. “We have to order vaccine at least eight months in advance and couldn’t have predicted the much higher response rate. We don’t give vaccine willy-nilly to anybody who asks for it.
“What is apparent is the Government’s failure to plan. Ministers have responsibility for wider public health, and part of that is contingency planning. That’s not the GPs’ job.”
In the Commons, Ms Hewitt urged doctors to prioritise the remaining stocks on those who will really benefit — those aged over 65 and younger people classed as being at clinical risk.
This year more vaccine was produced than ever before, but anecdotal evidence in late October had suggested there may be a shortage, she said.
She added: “The current problems may be due to a combination of factors, such as under-ordering of vaccine and vaccination of the ‘worried well’. Awareness may also be higher this year due in part to the level of media interest in the threat of avian flu.”
Angry exchanges followed Ms Hewitt’s statement, during which she was accused of blaming doctors instead of taking responsibility herself, and the department was charged with gross complacency.
Andrew Lansley, Shadow Health Secretary, said: “The simple fact is that people have been going to their GPs to get their flu jabs and told that supplies have run out.” Pointing at Ms Hewitt, he said: “You don’t accept responsibility for this. You should have. The delivery of the programme is the Government’s responsibility. It is not good enough that you blame the GPs.”
He added: “You have not even remotely begun to explain what has gone wrong. We have a crisis. What are you going to do about it?”
Ms Hewitt said that in previous years the GP-led arrangement for buying flu vaccine had worked well, but added: “In view of what has happened this year, I am reviewing the arrangements and will consider this matter urgently.”
Doctors across the country are reporting that they have run out of vaccine, after more patients than expected turned up for immunisation. Dr Kailash Chand, Greater Manchester’s BMA representative, estimated that a fifth of practices in the North West had run out of the jabs. He said: “Just weeks ago, the Government said there would be no shortage. Now they have run out.”
Doctors also denied that they were treating the worried well, saying that the demand came from patients who were fully entitled to vaccination on the NHS. Dr John Havard, a GP in Saxmundham, Suffolk, said: “Those who are coming in are largely the people we are always trying to persuade. This year they are a bit scared, and demand is up.”
Most GPs do not have the option of sending back unused vaccine, so over-ordering costs them money. They are not paid for patients outside the at-risk groups, so have no financial incentive to vaccinate the worried well. Dr Vautrey added that in many ways it was a good thing uptake had been so high. “It means a higher level of protection against seasonal flu than ever before,” he said. “That can only be helpful.”
WHAT WENT WRONG?
Q Are GPs really responsible for the shortage, as Patricia Hewitt charges?
A They place the orders, and administer the vaccines, so if the two don’t match they are responsible, technically. The question is whether it is fair to blame them for a rush to the surgeries they could not have predicted early in the year, when they placed their orders.
Q Are the “worried well” responsible?
A Impossible to say, but doctors insist that the surge in demand has come from the at-risk groups, not fit thirty- and fortysomethings. The Government has no evidence to refute this.
Q Will Britain run out of flu vaccine?
A That seemed almost certain before the fuss broke out yesterday, and seems absolutely certain now.
Q Why can’t the Government or manufacturers keep larger stocks, or step up production quickly?
A The blend of vaccine changes annually to match the viruses that are prevalent. So last year’s vaccine wouldn’t work very well. Production is a time-consuming process, involving growing the vaccine on fertilised hens’ eggs. Vaccine manufacturers have to place orders for eggs six months or more in advance, because millions of eggs are needed: two to three per vaccine dose. The production process itself takes five to eight months. Ramping up production, using this antiquated technology, is very difficult.
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