By Rebecca Smith, Medical Editor
Telegraph
Published: 7:30AM GMT 09 Dec 2009

Children aged between six months and five years were supposed to be offered the vaccine from the middle of December.

However, that is now in doubt after negotiations between the Government and GPs over how the scheme would be administered broke down.

The sticking point in the talks was over how GPs and clinics would have the time for the extra appointments without losing out financially.

The Daily Telegraph understands ministers would not agree to relax the target that GPs must see patients within 48 hours in order to free-up time for the vaccination programme.

GP practices lose substantial amounts of income if they miss the 48-hour target.

However sources at the Department of Health claimed GPs wanted more money for administering each vaccine than the £5.25 that was agreed early in the discussions – an allegation the British Medical Association denies.

Local arrangements will now have to be made with the NHS in each area negotiating separately with their GP representatives over what tasks practices can drop in order to free up time.

Children under five are the group most likely to be admitted to hospital with complications from swine flu. Admission rates are still rising in young children even though overall, new cases of the virus are dropping.

GPs are already offering the swine flu vaccine to nine million people in the priority groups, including pregnant women and people with long-term illnesses.

Adding three million healthy children to the vaccination programme at the same time would have put greater time pressures on surgeries at their busiest time of year, family doctors argued.

Andy Burnham, Health Secretary, said vaccinations for children would begin before Christmas but Dr Laurence Buckman, chairman of the British Medical Association’s GPs Committee said this would now be ‘extremely difficult’ for most practices.

The age group involved means it is highly unlikely any vaccination programme could be carried out in schools without the assistance of GPs.

Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, said “We sincerely wanted to be able to reach a national agreement with the UK governments about a process for vaccinating the under fives against swine flu.

“Unfortunately this has not been possible, because the government would not support adequate measures to help free up staff time. At the busiest time of the year for general practice, with surgeries already dealing with the additional work of vaccinating the first wave of at-risk groups, we felt this was vital in order to ensure this next phase could be carried out quickly.

“We appreciate that parents of young children might be worried when they hear that there will be no national framework and want to assure them that this does not mean their children will not be vaccinated.”

A spokesman for the Department of Health said parents of young children will receive information about the vaccines as soon as local plans have been put in place.

A statement said: “We hope many GPs will still decide to vaccinate under fives. But where GP practices do not wish to vaccinate this group, PCTs will determine whether vaccinations will be offered through other local GP practices, their directly managed staff (e.g. health visitors, district nurses etc) or by arranging with alternative providers (e.g. community or hospital paediatric services, pharmacies etc).”

Mr Burnham said: “It is disappointing that we have not been able to come to a national agreement with GPs to vaccinate children from six months to five years old.

“But we are now getting on with the job and asking local health trusts to put local plans in place so that vaccination of these children can begin seamlessly.

“The supply of vaccine is increasing and we should therefore be able to meet the demand for vaccine and begin vaccinating children before Christmas.

“I want to take this opportunity to thank NHS staff for their exemplary efforts to put in place this vaccination programme swiftly and remind people in the priority groups for vaccination to ensure they are protected.”

The fee of £5.25 per vaccine administered and is the same rate as GPs receive for vaccinating people in the priority groups.