Flu: last time around

Last year's outbreak put the health service under pressure

The NHS was thrown into chaos by last year's flu "season". BBC News Online reported on how the pressure mounted.

At the peak of the crisis in January 2000, both Chief Medical Officer Professor Liam Donaldson, and Health Secretary Alan Milburn both claimed that an "epidemic" of flu had laid the NHS low.

In fact, the 2000 outbreak, while causing a great deal of misery and severe illness, as well as costing an estimated 20,000 lives in flu-related illness, was nowhere near being an official epidemic across the whole UK.

To qualify, there must be at least 400 cases of flu reported per 100,000 population.

At its peak, the rate was just over 200 in England.

A lesser percentage of Scots need to be ill to make it a bona fide epidemic, and this mark was passed during a handful of weeks during the winter.

In comparison, the outbreak in 1989/1990 romped past the 500 mark.

The outbreak started slowly, but started to accelerate fast over the Christmas holiday period.

The elderly were particularly at risk

It was a severe infection, often weakening patients and making them vulnerable to chest infections - which are very dangerous in the elderly and weak.

Despite there having been in theory statistically much worse outbreaks only a decade before, the havoc wreaked within the NHS was notable.

Hospitals and GP surgeries were flooded with thousands of flu victims needing urgent medical assistance.

By early January, this influx, coupled with staff sickness leaving hospitals short, left many struggling not only to tend the living, but even to store the dead.

At some hospitals, refrigerated lorries were used as temporary mortuaries as existing facilities were overwhelmed.

The knock-on effects were immense. Faced with such a huge number of very ill patients, often requiring intensive care treatment or at least very long stays in hospital, the only option for most trusts was to start cancelling routine planned surgery hand over fist.

This did not simply mean non-urgent operations, but also some which needed to be done as soon as possible.

One case which came to light was that of Mavis Skeet, due to have an operation on her cancer of the oesophagus in January.

However, the operation was put back four times because Leeds General Infirmary had no bed for her.

When one was finally available, the cancer had become inoperable. Mavis Skeet died a few months later.

Damaging publicity

While cases like these made the headlines, in the background huge amounts of damage were being done to the government's pledge to reduce waiting lists by 100,000 people.

Mavis Skeet: died after surgery cancelled

It took months for the initiative to get back on track.

By the middle of January, the pressure on the government as well as the health service was immense.

Critics claimed that many of the problems were due to chronic staff shortages of nurses, with the knock-on effect that fewer intensive care beds could be properly staffed.

In addition, they said, hospitals were finding it difficult to discharge less seriously-ill patients into dwindling numbers of nursing home beds.

The root cause as they saw it - pure NHS underfunding, leaving the service unable to cope even with an average-sized flu outbreak.

The World Health Organisation had already condemned the UK's preparation for the virus as the worst in Europe.

Tony Blair conceded in interviews that the NHS was "underfunded", and pledged to bring health spending up to the European average.

The billions-strong cash injection that followed is forming the centrepiece of government policy in the run-up to the next election.