Hi Jeremy
> Thanks for your comments. Someone once told me that if vaccinations were
> necessary for employment purposes then they should be given free
> of charge.
Nothing is ever free - so we need to ask, who is paying the fee for the
medicine/administration/consumables(plasters,sterets
etc)/heat/light/staff/building etc...?
If something is necessary for employment purposes then in my view the
employer should pay - by way of a fuler explanation.....
51 years ago the NHS decided to adopt a model of independant contractors
status for general practice which for the majority of us has not changed
IE As a GP I am a self employed businessman -GPs do not work for the NHS -
they have contracts with Health Authorities to provide services which may or
may not be their only contracts
My main contract is with the health authority to provide "general medical
services" for which I recevie a capitation payment(and immunisations is not
coovered in GMS) - in adition there are Items of Servcie fees for a variety
of other activities (lumps and bumps removal, contraceptive
services,temporary resident advice....) which augment my gross income from
ths contract
In return I run the business ( and therefore have gross expenses) , employ
15 people (and thereby have to keep up with all the responsibilities of an
employer as well as doctoring) and own the building in which this "NHS"
activity takes place thereby taking responsibility literally for the loo
roll to the tiles on the roof
So you will see that with this background it is not surprising that many GPs
get irritated with "dumping" of work from employers or secondary care
without a fee attached or promise of a suitable contract of terms for the
work
> What happens at your practice?
For the odd patient on my NHS list who requests it I do give a course (and
am happy with the small profit I make on buying bulk jabs and the amount the
NHS reimburse for dispensing). For employees of the small companies I look
after (inc a sewer diving firm) I charge 35 ukp per jab for Hep B
Any concerted effort by a company/NHS trust to have there employees
immunised systematically by sending them to me( coz its "free" on the NHS")
without prior arrangement of terms would meet with a simple no accompanied
by my terms of business
Sorry to sound so long winded but an awful lot of misunderstandings arise
because of basic ignorance of how GPs get paid
If I worked in a different model (IE salaried/40-60 hours per week then I
would be more than happy to fill those hours with immunisations, although I
suspect that my new managers would take a different view ;-)
cheers
--
Dr Mark O'Connor
www.physician.org.uk/
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