To think my doctor has overstepped the mark by sending me this letter?

[evilplaguerat]

I am a regular but I'm afraid I have namechanged because there WILL be hostility on this thread

Basically my ds2 hasn't had all his preschool immunisations, because when we received his initial appointment we deferred it because we really weren't sure we wanted him to have the MMR booster (I KNOW what many people think of this attitude, I really do)

I've just had a letter from our GP which starts

"Dear Mum and Dad

It is with some alarm that I've heard from our practice nurse that XXX has not attended multiple appointments for his preschool immunisations"

whatever you think about children not being immunised - does my GP have the right to order me to immunise him? Or am I right in feeling that it's legally our decision and the letter is inappropriate?

To be clear - I'm not asking for views on parents deciding not to immunise (although I realise I am going to get them anyway), I'm asking about the legal position of the parents and the GP and whether he can in fact strong-arm us into having them if we don't want to.

The "Mum and Dad" bit is cheeky and I'd be irritated by that, too. "Dear Parents" is a less... cosy group term. But I'm actually relieved doctors are taking it seriously enough to write, whether concern or lucre is their reason.

The US Centre for Disease Control has really good info on MMR safety. Offers a side-by-side comparison of the studies for both positions, (there are no peer reviewed double blind lones on the anti side, iirc) as well as a reasoned explanation of why the singles aren't offered/advised. (Japan withdrew the MMR and offered only single rubella and measles vaccines, after a scare about the mumps bit. Kids started dying of measles after that, which hadn't happened in years. MMR was reintroduced. The vaccinations in Japan were compulsory, iirc, as they are in many US states.)

The premade appointments are infuriating, though. The first arrived after I'd already taken him to get that jab, as they were very late about it, and since then he's had fevers twice when due more, so we've postponed. All this means they automatically make appointments which are totally out of whack with the schedule he's actually on. And half the time, when I ring up to cancel, they've not even informed the practice. The reception staff hate it - say they often get parents bringing kids in with a premade appointment letter, and no appointment has been made by the PCT.

YABU.

Your GP has expressed concern that your child, his patient, has not recieved a reccommended immunisation. The letter also suggests that you have missed appointments rather than cancelled which may or may not be the case but if so it does give the impression that you simply haven't bothered rather than reaching aninformed decision which differs from the NHS guidance.
Whilst the use of "Mum and Dad" is

irritating it is for ease and economy of time rather than the deliberate effort to patronise you that you perceive it to be.
I think that "concern" may have been a more appropriate term to use rather than "alarm" but but that rather depends upon therates of the diseases in your area imo.

As an aside I don't think that vaccination targets for children are part of the QOF anymore. As far as I can tell they have been replaced by "Child development checks are offered at intervals that are consistent with national guidelines and policy" but that is just from a quick look at the website and something lurking in the back of my mind from rl.

I agree the letter sounds a bit , but I genuinely wonder why anyone who isn't a trained immunologist (or at least, a medic or a biologist working in a relevant field) would think their own "reading and research" could cut it against NHS guidance based on knowledge of the research literature?

This is not decrying the research skills or intelligence of MNers who decide not to vaccinate kids; but if you know the research literature on epidemiology of infectious diseases, you vaccinate your kids.

Perhaps that means doctors and scientists are all brainwashed by vaccine companies, but I imagine it would more likely be down to Drs/scientists either knowing the research basis of the NHS guidance, or knowing that the people who produce the guidance are better qualified to make a decision on the matter.

Evilplaguerat (cool name ) - Im not trying to say you lack the ability to do the research, far from it - but is there any reason you would be better qualified to make decisions about immunology than a public health epidemiologist/immunologist/GP?

(dons hard hat and runs and hides...)

No, he shouldn't speak to you like that. I think it's actually unprofessional to use the word "alarm." He's out of order.

I got loads of letters like that as dd2 has bad reactions to jabs,got so pressured by GP i finally gave in and dd2 had her booster(not MMR the first jabs )They gave her the jabs her eyes rolled back,her arm swelled to twice its normal size,when she came round she vomited everywhere.Her arm was swollen for 2months and she was ill for weeks after,she was 9 at the time.BUT we never got another call or letter about it.
Its up to the parent to choose when and how they vaccinate their children so YANBU.

I think the Dr is obliged to do what he feels is in the best interest of the child

concerned would have been better than alarmed, i get reminders like that from optician and dentist all the time.

GP did not write the letter himself, was probably a temp or work experience youth!!

It is probably a standard letter sent off every so often to those whose children have passed their dates and not got in touch recently. 9 times out of 10 the scenario would be either that the family have moved on and not told them or hesitate due to lack of information. This kind of covers such situations. Agree "alarm" amy be strong but as it is so generally addressed , it reads somewhat less personally anyway. The doctor may be aware of an outbreak of the relevant diseases and have been asked by PCT to review uptake.

Haven't read the entire thread so excuse any repetition...

the letter is obviously a "standard letter" that goes out to all parents- not just you.

The Practice has targets to reach which, I think, affect the funding they get by the Government. They will be aiming for something like a 98% take-up.

You cannot be forced to have your child immunised, but neither do you have a right to be on the Practice Register- so in theory your GP could ask you to leave, and refuse to treat you at their Practice.

Sorry if others have already said this.

greensleeves- It is all about targets..I had the self-same letter from my GP and when I sent my Mum in to explain (my reason being different from yours, in that dd has had her MMR booster here in Italy, but because we spend part of the year in the UK sometimes she has jabs there so we figure on their books) and the receptionist said, "oh we have to send them out, because we tick a box for the LHA for each child we vaccinate and then we get extra dosh ha ha ha".
Was a bit gobsmacked actually, that the reason for the letter didn't actually seem to be related to health issues at all....but another fiver in the kitty.

YABU

From two points really, 1)its not his personal opinon its professional. If you had missed an appt by mistake you'd be upset if he didn't tell you. 2)Even if it is just for the money, how can they give you a btter sefice without more money?

He sent you a letter, you can choose to ignore it if you want, to get funny about a couple of words is imo losing the point of the letter.

I wonder if the letter is a standard template, and the person sending out the letter is meant to replace "Mum and Dad" with the actual parents names.

In response to the OP, YABU. Obviously the GP cant force you to vaccinate your children, but its entirely reasonable of the GP to express concern.

Message withdrawn

MissSunny.... today is a Sunny day, thank you!!!

I think the link between cash and uptake still exists, but doctors want it abolished for the exact reason that it stops parents believing that their sole interest is the patient.

There's a really handy overview of vaccination on the CDC site, which counters the arguments against vaccinating in general pretty well, IMO (far better than the UK info).

The CDC page on the MMR is here, and the side-by-side comparison of the evidence for and against supported by them is here. The WHO statement is here and the NIH here.

I'm amazed that people honestly think they can interpret the data better than the WHO, the CDC, the NIH and the public health officials of every country on earth, on the basis of a book written by a guy who sells single vaccines, alarmist news reporting (Ben Goldacre is great on that) and the echo chamber effect of internet chat rooms. Low uptake is affecting people who are too small to have had their jabs yet, who are vaccinated on schedule but where the jab has failed to take - or whose health is too vulnerable even for vaccination. I tend to be big on respecting other people's parenting decisions (bottle, CS birth, daycare, I'm often amazed by how many people think they have a right to lecture an engaged and loving parent) but the problem with refusing vaccination is you're effectively choosing for other people's kids as well. Vaccinating parents' own choices are supported by all the respected literature and health bodies on the planet, and are protecting your kids as well as their own. Your decisions aren't supported by much, medically speaking, and expose their kids to risk. This is therefore probably going to involve the odd letter, expressing alarm.

YABU.

The letter had the desired effect didn't it? It made you sit up and take notice.

The use of the word 'alarm' may be construed as overdramatic but bear in mind the majority of parents that will receive that letter are the ones that forget repeated appointments, cancel repeated appointments because they are busy and medical appointments are seen as low priority to them, and the ones that just can't be arsed to take their children for anything.

The doctor probably has no idea what category you fall into so sends a strongly worded letter in the hope that at least a few parents will respond.

am feeling really bad we spaced those two appointments now.

need to get her boostered up before school/nursery starts again as DD1 will be entering primary and DS is too young for MMR until next year.

ds1 had all his jabs including the MMR but not the booster.

ds2 has had his up until he was due his 12m jabs and i stopped there. he has not and will not have the MMR, not for any reason.

Now if anyone thinks i have made an uninformed choice...you are very wrong.

Excellent post Qally.

Informed by what though Lady?

JoPie, how is personal experience for you? I think thats enough information for most parents to go by.

I don't find personal experience to be very informative in making medical decisions, what with them being so individual, unscientific, unrepresentative, and the fact that I have no medical training to be able to interpret my own experience in any meaningful way.
But thats just me.

Jo,
I let ds1 have the MMR against my better judgement. Basically I caved in to the pressure of the HV and Dr's when ds1 was 4 1/2 yrs old. And man do I wish I had gone with my instincts not to let him have it. He changed so drastically that I am this time going with my instincts and DS2 will not be having it, I have had many years to decide if I had another child what I would do 9 to be exact and nothing can persuade me that letting ds2 have the MMR is the best thing for him.

I got countless chasers, even phone calls from my GP's surgery. I ignored all of them and did what I thought was best for my ds.

why do you feel the need to namechange for this epr?? is it such a sensitive / personal issue?? as you were...

tbh ,I don't think this is illegal.DP gp has a note up in surgery saying he doesn't give the MAP for religious reasons.It isn't like he is saying "Hey arsehole,vaccinate your child or else!"I guess it could be perceived as a little patronising and the M+D thing is a bit off (wHAT ABOUT LP?),but it isn't actionable.Given health guidelines he is acting in good faith even if the wording is a bit off.You do not have to act on the letter.Hth.You could always change your gp if you find the letter totally an antithesis in regard to what you believe in.