Negotiations break down in swine flu jab program for children under five .

Negotiations between the government and general practitioners have broken down regarding a proposed plan to vaccinate children under five for the swine flu.

Children between six months and five years of age in Ireland, Scotland, the U.K., and Wales were expected to be able to receive the swine flu jabbeginning in mid-December.

However, due to discrepancies in how GPs would be able to make time in their schedules without losing income, the negotiations broke down on Tuesday. The Daily Telegraph reports that demands by ministers for GPs to see patients within a 48-hour time period were too strong. GPs feared that income penalties would be too high when missing the 48-hour window.

Dr. Laurence Buckman, Chairman of the  General Practitioner’s Committee, told the Telegraph: “We sincerely wanted to be able to reach a national agreement with the U.K. 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.”

Dr. Dean Marshall, representing Scotland’s GP’s Committee, explained that the decision made by GPs was based on the 48-hour rule and its “unfair” constraints.

“If I am being monitored on access, then my access isn’t going to be as good if I have got an extra 700 appointments for children,” Dr Marshall told The Scotsman.

“So it wasn’t about us doing it or not. It wasn’t about more money. It was about how we were going to fit that in, in addition to everything else we are doing at the busiest time of the year. It seems slightly unfair to be monitored on access, which could result in defunding my practice at a time when I am prioritizing access for children.”

Dr. Brian Dunn, Chairman of the British Medical Association’s Northern Ireland GP’s Committee, confirmed that time was an issue, telling the Belfast Telegraph, “The government would not support adequate measures to help free up staff time to deliver this phase of the H1N1 vaccination program in what is the busiest time of the year for general practice.”

Due to the breakdown, negotiations will be needed on a more local level. Local NHS offices are expected to begin working with GPs in their regions to come to an agreement.

Representing the Welsh GP’s Committee, Dr David Bailey told Wales Online: “I hope that NHS boards and local medical committees work together to reach agreement swiftly on local deals that provide the much needed flexibility that practices require in order to cope with their current workload as well as delivering the vaccination program.”

It’s not clear at this time if a universal agreement will be reached between GPs and the governments. Many GPs have already made a good-faith effort to fit more children requiring the vaccination into their schedules despite existing time constraints.