Government declares epidemic

Britain could be heading for the worst flu epidemic in a decade, health secretary Alan Milburn said today.

But a leading flu expert disputed government claims that the outbreak had already reached epidemic levels. Doctors and health service bosses said that bed cuts, and not the flu outbreak, were responsible for the huge pressures on hospitals across the country.

Thousands of people are being told that their operations will not go ahead this week as hospitals cancel routine surgery to cope with the flood of emergency admissions.

Hospitals in Bristol, Brighton, London, Nottingham, Leeds and Newcastle upon Tyne are among those who have cancelled all non-urgent operations.

Official figures published last week showed that 144 people per 100,000 in England had consulted their doctor with flu-like symptoms. An outbreak is judged to be an epidemic when 400 people per 100,000 are suffering.

But in a statement to MPs, Mr Milburn said that the real toll was far higher as people were using the nurse-staffed helpline NHS Direct and pharmacies to seek help and were not being included in the statistics.

He said: "The chief medical officer professor Liam Donaldson has advised that the official figures only reflect the people who have consulted their doctor and undoubtedly understate the true size of the outbreak.

"He considers that there are people who are missing from official statistics, because instead of consulting their GP they have used alternative routes of advice. This means that, unless present levels of influenza activity peak soon, we could be heading for the worst epidemic in the last decade."

He added: "There can hardly be a family in the land that has not been affected by flu. Everybody knows somebody who has had it."

Mr Milburn insisted the NHS was coping with the crisis and paid tribute to staff.

His claims of an epidemic were disputed by Dr Douglas Fleming, director of the Birmingham research unit of the royal college of general practitioners and a leading expert in flu. He said: "Conventionally we have used the word epidemic to describe a particularly unusual winter.

"We haven't used epidemic to describe winters which are quite bad for flu but haven't reached that higher level.

He added: "The figures used to describe an epidemic are a convention and were agreed by the department of health. I do not know whether there has been a change of policy but that certainly was the convention we have always worked with.

"I would like to know what the reason is for calling this an epidemic if the figures have not been changed and it does concern me slightly."

The government's emergency beds service said there were 36 intensive care places available in hospitals across England this morning. The situation is an improvement on last week when at times there was not a single free intensive care bed.

Mr Milburn said the government had provided a record number of intensive care beds this year.

Doctors' leaders and the NHS confederation, which represents health authorities, both said the pressures on hospitals had been triggered by bed cuts and efficiency savings.

Dr Peter Hawker, chairman of the consultants committee of the British medical association, said: "The majority of emergency admissions are patients with medical problems, such as severe respiratory disease.

"Yet again, because we have too few beds in the system, we have medical patients scattered throughout the hospital on surgical wards and wherever we can find a bed for them."

He added: "We expect health professionals to rise to an occasion in a crisis, such as a major accident or disaster, and they do so magnificently.

"We should not have to rely on that level of commitment simply to get through the winter. The underlying cause of the pressures are too few beds, doctors and nurses."

Stephen Thornton, chief executive of the NHS Confederation, said that tough efficiency targets meant that average bed occupancy was 90%, making the beds crisis during the winter inevitable.

"The government's own research shows that if hospitals operate at occupancy levels of more than 90% it is an absolute certainty that there will be periodic bed crises however well they are managed," he said.

"The system needs to stop being run at dysfunctional levels of capacity. It is not efficient to run a system at this sort of level. It is demotivating for staff and leaves the NHS with little capacity to cope with even small fluctuations in demand."

Shadow health secretary Liam Fox said Mr Milburn's statement was "very long in complacency and very short in detail".

He said people would be asking: "How can it be that with the world's fifth biggest economy, at the beginning of the 21st century, that something as predictable, as cyclical and as common as flu can cause the system to be breaking apart at the seams?"

Dr Fox said the Government's "obsession" with its waiting list initiative had left the service over-stretched, with too little spare capacity for any crisis.