Specialists ‘could refuse to give vaccinations’

Image caption Sixty-four per cent of the children in England were fully vaccinated during school holiday visits last week, says NHS England

Patients under five needing certain vaccines may be denied an injection if their GP is available to treat their condition, a survey of doctors has found.

Two out of five specialisms had practitioners who would refuse to prescribe or dispense certain vaccines – increasing to two-thirds in paediatrics.

Some 40% of GPs said they would refuse or could not remember seeing a specialist trained to inject the vaccine – a policy at NHS England.

GPs said the issue was a case of “good medicine versus good patient care”.

Yet experts stress the problem is much more widespread – with A&E departments in some areas also failing to fulfil new legal targets for immunising all children.

At the same time, NHS England figures for the annual rolling school holiday period between 15 August and 5 September showed only 64% of children up to five years old had received the four recommended vaccines – against the target of 95%.

The NHS England response said: “Some GPs say they are not in a position to help children receive vaccinations because their practice is not an appropriate place for the administration of such medications.

“GPs may wish to consider that they will be providing the required vaccination as well as more general medical services, and so may not always be able to fit that role.”

Other researchers said it had no evidence of a high incidence of doctors refusing to give patients the vaccines, but could confirm demand for such practitioners existed.

The findings emerged in a survey conducted by charity Voice for Children, which is part of the Nuffield Trust.

The health group said its findings showed the divide in UK health was “ripe for reform”.

Several other problems were being created, as well as the “potential crisis” of an under-funded NHS, it said.

Jo Scott-Clarke, director of Voice for Children, said: “The professional outcry that greeted an immunisation tribunal was apparently nowhere to be seen in this survey.

“Though GPs were not found to be planning against their own patients, it is not clear how prescribing and dispensing vaccinations is ultimately going to improve care for patients and help meet targets.”

The survey, which looked at 43 types of specialist clinical assessment, came up with a range of other findings.

It found almost half of gynaecologists and paediatricians would refuse or not recall seeing a specialist trained to give the vaccinations.

For 11% of GPs, that figure increased to two-thirds.

Additional research in 14 clinical specialisms found that 52% of consultants would refuse to hand out specific prescriptions or stop giving vaccines.

An international child health group said it was “incredibly worrying” to have doctors refusing to give vaccinations out of choice.

The Campaign for Immunisation’s chief executive, Jonathan Montlake, said: “These shocking survey results show doctors can be irresponsible, neglecting the health of their patients in order to maximise their own financial and professional return.

“This culture of one size fits all vaccine policy is totally undermining the goals of health professionals. We have strong scientific evidence that immunisations benefit children, not harm them.”

Who is at fault?

There was also strong suspicion that GPs were not in favour of writing out prescriptions for certain vaccines – although the NHS experts said all of the medicine that many doctors prescribed was safe, effective and necessary.

According to NHS England the process for when doctors wrote out vaccines had improved significantly in recent years.

As well as allowing under-fives to get 11 vaccines with a single visit during term-time, it now permits three shots for younger babies, two babies and a five-year-old in the same doctor’s office.

Patients can also get an extra jab for a 10th child or for a partner of a family.

In a statement, the authors of the Voice for Children report said “it is depressing that only half of the doctors responding to this survey reported seeing a specialist offering guidance to write vaccinations”.

Image copyright Getty Images Image caption In the US, a court case has started over whether paediatricians should be able to refuse to inject vaccines on religious grounds

They said: “There are increasing demands from families and now the demands from those employed by the NHS to treat parents of children with complex healthcare needs, including those affected by autism spectrum disorder.”

They suggested that reform was needed and recommendations would be published later this year.

The findings come as a federal court in the US considers a lawsuit by parents of children with autism who say there should be “no religious exemption” from vaccination.

As well as autism, the study points to stress, grief, and depression as common reasons for parents

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