The flu jab rip-off
As virus rates soar, private GPs charge £45 — for an £8 vaccine
PRIVATE GPs have been accused of cashing in on the flu crisis by charging as much as £45 for a vaccine that costs the NHS £8.
And some clinics are charging up to £75 for a nasal immunisation spray for children that costs the health service £18.
Although patients in certain ‘at risk’ groups – including the over-65s – get vaccinated for free on the NHS, the majority have to pay privately.
They can get it either from a pharmacist or a private GP clinic, as their own NHS doctor will only have enough stocks for at-risk patients.
Many private clinics have seen a surge in demand in the past week after a sudden rise in flu rates, against four strains of flu. While which are twice as high as last the more reasonable GP surgeries year. Figures yesterday showed are charging between £10 and £15 cases had increased by a third for this type of jab, many are making compared with last week, but this patients pay £30 or more. is likely to be an under-estimate. The Dr Arun Ghosh clinics –
An investigation by the Mail has which have five surgeries in Liverpool, uncovered a huge variation in Manchester and Cheshire – prices charged by private GPs for and the Surrey GP in Guildford the same flu jabs. both charge £45 for the jab.
The most effective vaccine is the The Oxford Private GP charges ‘quadrivalent’, which protects £40, the Fleet Street Clinic in central London £35 and the Same Day Doctor in London and Manchester £30. The same vaccine is available for £15 at the Walcote Practice in Winchester and £11.85 at the Newcastle Premier Health Centre.
Two clinics – the Oxford Private GP and the Private GP in Leicester – are charging £75 for a nasal vaccine for children. The same spray costs £32.50 at the Newcastle Premier Health Centre – although it is now out of stock – and £45 at Winchester’s Walcote Practice.
Justine Roberts, chief executive of the Mumsnet website, said: ‘It’s a great shame if some clinics are taking advantage of parents’ fears by ramping up the price.’
Liz McAnulty, chairman of the Patients Association, said: ‘There should not be a cost barrier to vaccination for patients, staff and carers who are not eligible to receive it on the NHS but want to be vaccinated anyway.’
Labour MP Chris Bryant said: ‘This is a scam. It seems private clinics are taking advantage of the problems being faced by the NHS and overcharging.’
Liberal Democrat MP Tom Brake said: ‘Money-grabbing by private health companies over flu jabs is an outrage.’
The flu vaccine is available on the NHS for over-65s, children aged two to eight, pregnant women and patients with long-term conditions such as asthma and diabetes. But most are offered a less effective jab that only prevents three strains. It offers no protection against a fourth strain currently circulating, B Yamagata.
For this reason, some patients entitled to an NHS jab have decided to pay privately for the more powerful four-strain vaccine.
Several Boots stores in the Midlands, East Anglia, South and South West said they had run out of the flu jab at the weekend. They blamed a sudden increase in demand and said supplies would be replenished immediately.
Provisional figures from Public Health England yesterday showed there were 4,128 confirmed cases of flu in the week up to January 14, up from 3,044 the week before.
But this only accounts for cases where the virus was detected in the lab, and the true figure is likely to be much higher.
The Mail contacted the surgeries charging £35 or more for the flu jab but most refused to comment.
Dr Arun Ghosh said his vaccines were more expensive because they are carried out in private hospitals where a doctor and paediatric nurse are paid to be present.
He added: ‘That’s where the cost is. I admit we haven’t made that clear on our website. If people said to us “I just want a flu jab”, we would probably say “you’re better off going to Boots or Asda”.
‘We often see vulnerable people like autistic children or people who have had reactions in the past and it has to be done in a hospital.’
The annual flu epidemic has suddenly become serious. Few could have missed the alarming headlines last week about the dramatic rise in cases — GP consultations for ‘flu’ up by 78 per cent, hospital admissions up by 50 per cent and intensive care admissions up by 65 per cent compared with the week before.
Nearly 2,000 people have now been hospitalised because of complications owing to this year’s flu outbreak, according to Public health england — and 85 have died as a result.
Worryingly, the danger is far from over, with the flu season set to last at least to the end of February, and possibly as late as May, according to the Department of health’s Communicable Disease Centre.
It’s not the flu virus itself that claims lives, but ‘almost always flu-related pneumonia, the most common cause of death from flu’, explains Dr Ben Marshall, a consultant respiratory physician at Southampton General hospital.
It’s been reported that the tragic death this month of Bethany Walker, 18, from Applecross in Wester Ross, Scotland, was due to flu-related pneumonia.
What many people may not realise is that there is a pneumonia vaccine that can help protect against the bacteria most commonly responsible for the disease, Streptococcus pneumoniae (also known as pneumococcus). This one-off vaccine can last for up to 20 years.
But while it’s been available for 17 years and is offered for free on the NhS to at-risk groups, uptake remains low — this includes the over-65s, with around a third (four million people) declining the free jab.
Uptake is even lower among people with conditions that raise the risk of pneumonia, including longterm kidney, liver and heart problems such as congenital heart disease, anyone with COPD (chronic obstructive pulmonary disease), diabetes and those having chemotherapy for cancer or on long-term steroids for severe asthma or arthritis — with just four in ten having the jab.
This is deeply worrying, says Dr Marshall. ‘We know the vaccine protects around 45 per cent of people over 65 and those with chronic illness, compared to around 70-75 per cent of those with healthy immune systems.
‘But this is still very worthwhile. For people of any age, I would recommend consideration of vaccination for pneumonia if there’s an underlying medical condition that might increase the risk of serious complications.’
experts suspect that one reason people don’t have the jab is simply because most don’t know about it. The rate of vaccination among the general population — who have to pay a £70 fee to a pharmacy to have the jab privately — is perhaps, not surprisingly, even lower than among at-risk groups.
And if they do know about the jab, many people think pneumonia is a serious concern only for people at the end of their lives.
Yet figures from the British Lung Foundation show that, even in healthy people, the risk of contracting pneumonia increases year on year — with those in their 50s, for instance, having a 40 per cent increased risk of contracting bacterial pneumonia compared with those in their 40s.
‘ There are clear benefits for people of all ages having a pneumonia vaccination,’ says Dr Richard Russell, a consultant chest physician at Lymington New Forest hospital and a senior lecturer at the Nuffield Department of Medicine at the University of Oxford.
‘Should a fit 30-year- old man have the pneumonia vaccine? As their doctor, I would support their decision to have the jab if that’s what they choose to do.
‘Although people are only offered a free vaccination for pneumonia over the age of 65, the fact remains that the risk of getting pneumonia increases significantly over the age of 50.’
And with fears that the flu jab is not as effective this year, there are concerns there could be more cases of pneumonia as a result.
‘People think of pneumonia as a relatively minor chest infection that is only dangerous to older people, but that’s not the case,’ says Dr Marshall.
The infection ‘is a killer’, adds Dr Russell.
WHY IS PNEUMONIA SO DEADLY?
PNEUMONIA is a rapidly progressing acute infection that affects around a quarter of a million people in the UK every year, killing on average 29,000 of them, making it the leading cause of death from an infectious disease and the sixth biggest cause of death overall in Britain.
The infection causes the clusters of tiny, balloon- like air sacs (known as alveoli) that lie at the end of the bronchial tubes in the lungs to become inflamed and fill up with mucus.
‘It’s the same gungy fluid that
we all cough up when we are beginning to recover from a heavy cold,’ explains Dr Russell.
But, trapped in the lungs, mucus becomes highly toxic.
The alveoli, he points out, play a vital role in getting oxygen-rich air into the lungs, filtering out carbon dioxide and sending oxygen into the bloodstream to nourish the body’s tissues and organs.
‘When this process stops working efficiently, you start to develop all the symptoms of pneumonia, including shortness of breath, chest pain, a high temperature and a bad cough,’ says Dr Russell.
‘If left untreated, oxygen levels in the body start to fall and you begin to suffer severe confusion, heart failure and, eventually, coma and death may result.’
Most at risk of dying of the disease are those who are older and frail, or who are already seriously ill.
Pneumonia can often be diagnosed by a GP by listening to noises in the chest and lungs through a stethoscope.
As with any fast- developing disorder, speed in diagnosing it is of the essence and symptoms can be confused with other respiratory conditions including the much less serious bronchitis or flare-ups of asthma, or smoking - related conditions such as emphysema. For patients and their families, the experience of pneumonia can be terrifying: one minute, they’re managing normal cold or flu symptoms — and the next, they find themselves requiring an urgent referral to A&E.
‘GPs sometimes have to make what can be a life -and- death decision on whether the patient can remain at home with the infection managed by oral antibiotics, or whether an admission to a hospital that at the moment is already chock -a-block is required,’ says Dr Russell.
WHY DOES FLU TURN INTO PNEUMONIA?
OCCASIONALLY, pneumonia can be caused by viruses, for instance occurring as a complication of the viruses that cause colds and flu. But it’s most frequently caused by the pneumococcus bacteria.
The bacteria can either be inhaled as airborne droplets delivered from someone’s uncovered cough, or reach the lungs via the bloodstream from a bacterial infection else - where in the body , such as the middle ear (a common cause of pneumonia in children) or the urinary tract (most commonly in older women).
‘This transmission is so simple because we’re all awash with streptococcus pneumoniae, the bacteria being one of several that colonise the respiratory tract, the sinuses and the naval cavity ,’ explains Dr Marshall.
‘But in someone with a healthy immune system, there’s little danger — you ’re only at risk of pneumonia when there’s a chink in your immune system armour.
‘That can occur for a whole range of reasons — because you have a chronic lung condition such as coPD or heart failure or kidney disease, or you are taking chemotherapy drugs for cancer.’
one of the major causes of poor immunity, though, is having flu. ‘Having flu can paralyse your immune system and can increase your risk of pneumonia by up to 100 times — and this can impact on the immune system for a few weeks after the infection has cleared up,’ adds Dr Marshall.
People can get clear of flu, then they suddenly become really ill from pneumonia that develops on the back of the flu, says Dr Rod Daniels, deputy director of the Worldwide Influenza centre in london. ‘That’s because the flu virus can really mess up your immune system.’
And so, while pneumonia can take hold at any time of the year , ‘it tends to peak during the flu season’, says Dr Marshall.
Interestingly, he adds, the flu vaccine, has resulted in a long - term downward trend in cases of fatal pneumonia — with just 17,460 excess deaths in 2013/14.
This year , however , there’s concern that the flu vaccine may be ‘only of moderate effectiveness, which means only 30 to 40 per cent of flu cases will be avoided among people who have the vaccine’, Dr John Mccauley , director of the W orldwide Influenza centre, said last week.
If certain conditions make you more at risk , another factor can be what doctors call ‘a poor cough’ — one that’s simply insufficiently powerful to clear the build-up of
mucus in the lungs. Shortterm, this buildup of mucus in the lungs is a normal, healthy immune response to a viral or bacterial infection.
But if the cough doesn’t easily clear the phlegm, bacterialaden mucus creates the perfect environment for an infection to take hold.
Another potential problem is having a degenerative disease, such as Parkinson’s, where a common symptom is difficulty swallowing, which inevitably interferes with robust coughing.
Chris Failes, a 72yearold retired estate agent and mother of two with two grandchildren, from Lymington in Hampshire, was diagnosed with Parkinson’s two years ago.
Last May, her GP told her that the cough she’d suffered from over a few weeks was a mild form of pneumonia and she was prescribed antibiotics and told to rest. Through the summer and early autumn, Chris’s cough seemed to improve — though, looking back, she says, the cough didn’t ever really go away and, in the runup to Christmas, it became worse.
‘I think it was the cold weather that made me so ill,’ she says. ‘It was horrible. My chest felt very uncomfortable and tight, as though I couldn’t breathe. I couldn’t get rid of the phlegm in my lungs. I had no energy.’
She spent Christmas in bed and was then put on a third course of antibiotics by her GP. But by January 5, her doctor referred her to a chest consultant at the local hospital — where scans confirmed she had pneumonia.
‘I remember sitting in the hospital waiting for the results, my body lolling over to one side, my head drooped down onto my chest. I felt so lifeless.’
Yet, once diagnosed in a timely way, pneumonia is relatively easy to treat — as is clear from Chris’s recovery.
‘A week ago,’ she told Good Health last week, ‘I was so ill that I couldn’t move my head.’
But after just three days in intensive care, receiving intravenous antibiotics and liquids, as well as oxygen to ensure that her bloodstream remained oxygenated, Chris was well enough at the weekend to be discharged and sent home.
‘My doctor has told me I won’t be back to normal for six to eight weeks. And I am under strict instructions not to overdo it,’ says Chris.
‘But it means that I am missing out on looking after my grandchildren aged 18 months and five years — they are so gorgeous. I usually look after them once or twice a week and it’s awful not be able to — though I hope I’ll be better soon and be spending time with them again.’