Doctors' Performance Standards Lowered for Giving More Flu Jabs

by Heidi Stevenson

20 March 2010

In the UK, Scottish doctors have been the most effective in pushing their already-ill patients into submitting to swine flu vaccines. The swine flu pandemic was a bust and its vaccines have been shown to be ineffective in the elderly. In the face of that, Scotland will reward doctors with high vaccine uptake by letting them skate on standards measuring the quality of their practices.

Defying all logic, Scotland will relax Quality and Outcomes Framework (QOF) standards for GPs who manage to get at least 50.7% of at-risk patients to subject themselves to swine flu vaccination. At-risk is defined as being between ages 6 months and 65 years and having chronic conditions. At best, this is an exercise in futility, since studies used to document these vaccines for approval have shown that people who are chronically ill generally gain little or no benefit from them.

So, to push doctors into administering swine flu vaccines to the people least likely to benefit, standards in other areas are relaxed. GPs who achieve the 50.7% vaccination threshold in at-risk people will be allowed to receive their QOF bonuses based on poorer outcomes than doctors who don't push swine flu vaccines aggressively.

Standards on Patient Experience (PE) 07 and 08 indicators are the ones that will be relaxed. These are new indicators to measure a GP office's ability to see patients within two days. This is a significant issue to patients, especially those who are acutely ill. The inability to see your doctor within two days—especially in those who are already chronically ill—can be devastating. At best, it requires going to an emergency facility, which, of course, results in less personal care and significantly greater cost to the National Health Service (NHS).

There is a significant amount of money involved in this plan. To being with, GPs get £5.25 for each swine flu dose administered. The QOF program can provide a bonus as much as £240,640 to a practice. By both paying up-front for each swine flu vaccination delivered, and then allowing a practice that delivers them to 50.7% of their at-risk patients to receive bonus money for providing poorer service to these same patients, a practice stands to take in a significant amount of loot. And the public can only lose.

This is utterly bizarre and twisted logic, benefitting no one but unscrupulous GPs who choose to play the system. Sadly, considering how successful Scottish GPs have been at scaring patients into swine flu jabs, there are plenty who have no problem taking advantage.

Now, we will see even greater deterioration of already-deteriorated services. Over the last few years, since GPs have been privatized, their incomes have risen steeply, while services provided have deteriorated. Between 2003, the first year of privatization, and 2008, their incomes rose 58 percent. Most have cut back on their hours, so they're now providing almost no after-hours care, which of course, results in an ever-greater burden on emergency services.

A Department of Health spokesperson said,

We have never set targets for vaccinations but we want to make sure that GPs who vaccinated high numbers of patients are compensated. This is in recognition of the extra work from swine flu vaccinations.

This statement is farcical. The GPs are already compensated, both by the NHS for each swine flu vaccine, and also by the QOF standards, which included bonuses for vaccinating at-risk patients for influenza and other diseases.

According to Healthcare Republic, the DOH claims that the plan is an incentive, not a target. That's a difference without a distinction. When a specific percentage of patients being vaccinated results in lowering targets for bonuses, it's both an incentive and a target.

A careful examination of the plan gives the strong impression that the real reason is to get rid of a massive vaccine stock. It appears that Scotland has learned the lesson that has recently been dealt to France, which came under scrutiny for trying to sell off over-purchased swine flu vaccines. So, it looks like the wasted money and misbegotten swine flu policy is being hidden behind a new policy designed to get rid of excess vaccines. The Scottish government is throwing yet more money at a failed project.

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