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A review of the seasonal flu programme, commissioned by the health secretary after the 2005/06 campaign, has proposed a graduated incentive scheme for GPs in England.

Under DoH proposals the system of individual GP practices negotiating discounts on the vaccine directly from manufacturers would end. Instead, the DoH would order for the whole of England and negotiate a single bulk discount.

The savings, of up to £30 million, would be used to provide incentives for GPs to increase uptake of the jab in patients under 65 in at-risk groups.

These incentive payments could replace the existing flu target scheme.

The 2006/7 figures showed that only 42 per cent of those under 65 in at-risk groups were vaccinated.

But North Somerset GP Dr Richard Lawson, warned that the government should be careful not to try and push flu vaccine on people, as it did seem to have associated side-effects (such as upper respiratory tract infections).

'If the government wants to do something about influenza, it should launch a stay-at-home-if-ill campaign,' he said.

sanjay.tanday@haymarket.com