Pharmacies in Waikato are delivering free flu jabs to older people this winter in a New Zealand first that has raised hackles with doctors.
Pharmacies around the country have been able to deliver the vaccinations to those who pay, but not free flu jabs.
That has just changed in Waikato where an initiative by the Waikato District Health Board, approved by drug-buying agency Pharmac and supported by the Health Ministry, means 23 Waikato pharmacies are now delivering the free flu jab - but only to those aged 65 and over.
For 73-year-old Hamilton resident Diane Booth and her husband, having their free annual flu jab at a pharmacy, instead of their GP, last week was a no-brainer.
"We have to travel for probably about 20 kilometres to the doctor, and it was so much easier just to go to our local pharmacy," she said.
The DHB's clinical director for primary care, Damian Tomic, said just 68 percent of the age group got the vaccination, and the DHB wanted to lift that to around 75 percent or higher.
"The 65 years and older age group suffer the highest rates of illness and mortality from catching influenza. It's a serious illness leading to hospitalisation with serious complications such as pneumonia, so we have decided to focus on that group."
He said the DHB still also encouraged people to see their GP for the vaccine.
"However there may be times when people find it more easy to go to their local pharmacy, in case their general practice is burdened by the number that they are immunising or their general practice might not be available when it's convenient for the person."
He said he would like to see greater integration in the community between health providers, such as pharmacies and general practice, but it needed to be well planned and not create extra work. The DHB was working to ensure that was achieved, he said.
GPs lose subsidy
Midland Community Pharmacy Group chief executive Cath Knapton said many older people welcomed the choice.
"There's no appointment necessary, they can just walk in off the street and have it undertaken. They have to wait around for 20 minutes but in some cases there's a mall, pharmacy or they're able to shop."
Ms Knapton confirmed the change meant pharmacists, not GPs, pocketed a $19.74 subsidy for each patient vaccinated.
"There is the feeling among some general practices that pharmacy is taking that money away from them, and we're just going back and saying that's not the intent.
"The intent is to mop up those patients that wouldn't otherwise be attending general practice to get their flu jab, or just about ease and convenience. If you don't have the time or appointments available, we can help."
She said pharmacies were delivering data to GPs about all the older people they gave the free jab to, so GPs had the information they needed.
GP Kate Baddock of the Medical Association's General Practice Council said GPs had not asked for help.
"General practice has not said, 'Please pharmacy, ease our burden'. They haven't said that at all. They see vaccination as an integral part of what they do, particularly things like funded flu vaccination, and we don't see this as an integrated move at all."
Dr Baddock said as far as she understood it, pharmacies had no responsibility to chase up hard-to-reach patients, or recall and follow-up patients.
"To be cynical, it's a bit like taking the icing off the cake," she said.
Immunisation expert Lance Jennings said this year's vaccine covered a virus known as H3N2, or the A Switzerland virus, which hit some elderly people hard last winter. He said it could do so again among those not immunised.
"So if we can improve the accessibility of seasonal influenza vaccine to the high-risk groups then I'm all in favour of other strategies being used."
"Professor Jennings said nationally just 64 percent of those 65 and over had the flu jab but the government target was 75 percent.
The Health Ministry said it viewed the Waikato initiative as a trial and was interested to see how it went.
Andrew Inder, group manager of community health service improvement, said a larger scale programme would require investment in the National Immunisation Register, to enable pharmacists to access it directly for data input purposes.