Immunization, practice records and the white paper.

The accuracy of all immunization records for a cohort of two to three year olds, registered with one general practice, was investigated. Information was obtained from practice notes, the practice computer, the district health authority records and the parents of those children whose records indicated they had outstanding immunizations. The combined results revealed a rate for completed immunization schedules of 72%, but the rate recorded by the district health authority was only 40%. All the records were defective because the systems for exchange of data were not functioning properly. The government's white paper on primary health care links practice income to performance, and immunization rate is one index of this. On the basis of the district health authority records, this practice would be wrongly penalized.