- A doctor's surgery has admitted striking a number of
children off its register because the practice will lose thousands of pounds
a year if they do not have the controversial MMR vaccination.
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- The Canbury Medical Centre in Kingston, Surrey, is not
meeting a government target of immunising 90 per cent of the children on
its list. If this continues the doctors will each lose a "vaccination
bonus" of £2,865.
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- The centre has informed parents that their children will
be treated as "temporary residents" rather than being on National
Health Service lists, and has blamed the decision on the Primary Care Agency
- the NHS body that pays the vaccination bonus.
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- The surgery's policy came to light when Karen Kennedy-Milne,
from Kingston, received a letter from the medical centre last Monday saying
that her daughter Abigail, who has not had MMR, would be de-registered
because she had not had all the recommended vaccinations.
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- The letter made clear that, if large numbers of parents
refuse vaccines, such as MMR - which has been controversially linked to
autism and bowel disease - doctors cannot meet their immunisation targets
and will not be paid the bonuses. Single vaccinations against the three
diseases are not available on the NHS.
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- Dr Josephine Boxer, the senior doctor at the surgery,
explained to Mrs Kennedy-Milne that her practice had recently been penalised
by a "large amount" of money because so many local families had
decided not to have their children fully immunised. Dr Boxer said subsequently
that the decision had been taken "for administrative purposes only"
and was made at the suggestion of the agency.
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- Although the surgery insists that Abigail will still
be entitled to the same level of care as previously, Mrs Kennedy-Milne
said: "We have always had excellent care from the surgery but I simply
can't believe that the service my daughter is now delivered is not going
to be affected.
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- "I was absolutely livid and also quite shocked,"
she added. "I feel so strongly about this. Not giving Abigail MMR
is my choice; it is my free choice. It is an educated decision I have made
through research, deliberation and discussion - and now my child's right
to a GP is being denied her.
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- "This goes straight to the fundamentals of why parents
don't trust the doctors on MMR. How can you trust the advice of somebody
who is being paid to do something? Our objection is to the possible danger
around the triple vaccine and we would consider alternatives, but we haven't
been offered alternatives - we have just been de-registered."
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- Mrs Kennedy-Milne said that her son Angus, four, had
not been vaccinated with MMR either and she anticipated a letter saying
that he too had been dropped from the list.
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- "I spoke to the Primary Care Agency and made plain
that I think this is absolutely outrageous," she said. "I then
received a second letter from the surgery saying that they would be continuing
to offer the full range of services and emergency care to my children .
. . and they would automatically be reinstated on the list at the age of
six.
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- "It seems to me that they are fiddling the figures;
they will remove as many children as they need to remove to get under this
bar. When I rang the PCA I was told they would not be finding another doctor
for Abigail, because as far as they are concerned it won't make any difference
to the service she receives. In other words they have a legal responsibility
- except where a child has not had the MMR because there is money involved."
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- Dr Boxer told The Telegraph that the practice had recently
had a "blitz" in which about a dozen children had been dropped
from the its list because they were not fully immunised.
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- "This is situation that we are being pushed into
by a government policy that penalises us for patients having free choice,"
she said. "At the moment we have a problem of a large number of people
refusing to have, in particular, the MMR vaccine. It is not for me to make
their decisions but I don't see why we should be penalised for them."
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- It made "absolutely no difference" to the care
the children received and a temporary resident form could be completed
for them when they attended the surgery, she said.
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- "I don't want to be put into this situation but
since we are providing full care it is the lesser of two evils," she
said. "Last year as a practice we lost £10,000 compared with
the year before, which is income but is also used to pay a proportion of
our staff and expenses in the practice. This is quite serious finance."
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- The immunisation payment system should be changed to
allow doctors to be paid if parents opted out of immunisations after they
had been told about them, she said, adding: "It makes it seem as though
we are persuading people to be immunised because we get paid, which is
not the case."
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- Peter Holloway, the chief executive of the PCA, expressed
surprise that Mrs Kennedy-Milne had been told that the practice was acting
on the advice of his agency and that his staff had told her Abigail would
not be allocated another doctor.
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- "This is not something I am aware of and I would
like to look into it urgently. The aim is to ensure that the targets are
a genuine reflection of the position in regard to immunisation," he
said.
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- Jackie Fletcher of the pressure group Jabs said: "This
just shows what a mess the NHS is in over vaccines. It is appalling that
it should have got to the state that money has to come before a child's
needs."
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- http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2002/11/17/nmmr17.xml&sSheet=/news/2002/11/17/ixhome.html
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