No agreement between GPs and HSE over flu vaccine

NO agreement has been reached between family doctors and the Health Service Executive (HSE) to administer the swine flu vaccine despite HSE plans to commence the vaccination programme in two weeks.

Yesterday, the HSE agreed to meet next Wednesday with the Irish Medical Organisation (IMO) after the union claimed a wide range of issues – including who would be held responsible in the event of a patient suffering an adverse reaction to the vaccine – had yet to be discussed.

Dr Ronan Boland, spokesman for the IMO GP committee, said the union had had “no discussion whatsoever with the HSE in relation to their [vaccination] plans” since both sides last met on July 22.

This was despite the fact that the IMO’s role is to deal with all contractual issues “around putting in place any new arrangements”, he said.

“Even on initial consultation and after talking with people who know more about this than I do ... it is clear that there are serious legal indemnity issues which have not been addressed which should have been addressed as part of the consultation process,” Dr Boland said.

He added that “legal impediments that exist within the arrangement [to administer the vaccine] will make it very difficult for many doctors to participate”.

However, Dr Kevin Kelleher, the HSE’s assistant national director of its health protection unit, said they had spoken with GPs in drawing up their plans, including the Irish College of General Practitioners (ICGP) “via” a GP member of its pandemic expert group.

But a statement from the ICGP said it was not within the remit of the ICGP “to agree arrangements for pandemic vaccination or any GP service and at no stage did the college involve itself in any such arrangements”.

“It is a matter of regret that the HSE/Department of Health have now issued a letter of offer to individual GPs without any engagement with the Irish Medical Organisation,” the ICGP said.

A spokesperson for the HSE said she was “satisfied there has been sufficient engagement with GPs” to help inform a letter of offer made by the HSE to GPs on Thursday.

The letter invites doctors to participate in the pandemic vaccine programme for a fee of €10 per dose. Vaccination involves two doses per person, three weeks apart.

The letter states that the HSE expects to receive quantities of the GlaxoSmithKline vaccine in the week beginning October 5 and that, “on this basis, we will distribute vaccine to participating GP sites so that vaccination can begin during the week of October 19 and 26”.

The letter also states quantities of the vaccine are limited.

With this in mind the HSE has changed its plan to first administer the vaccine to frontline staff. Instead, the vaccination programme will begin with “at risk groups” aged six months to 65 years and including the younger (under 65) chronically ill and pregnant women.

GPs have been advised to report any side effects of the vaccine to the Irish Medicines Board. They have also been asked to inform the HSE by October 9 if they intend to participate in the vaccination programme.

To date, the Pandemrix vaccine produced by GSK has been licensed and yesterday, the European Medicines Agency recommended to the European Commission that an additional vaccine – Celvapan from Baxter – be granted a marketing authorisation.