Peers Question Readiness for Next Stage of Swine Flu Pandemic
House of Lords committee warns that UK may struggle to cope with expected second wave of virus
The UK may not be adequately prepared to cope with the expected second and probably more lethal wave of the flu pandemic expected in the autumn, an expert committee of the House of Lords warned today .
The science and technology committee, which has been holding hearings as the pandemic has evolved over recent months, expressed disquiet over some aspects of the government's preparations in an incisive report.
The committee was particularly concerned by delays in the rollout of the full National Pandemic Flu Service, which is supposed to take the strain off GPs, and the possibility of a shortage of beds and staff in hospital intensive and critical care units, which could be overwhelmed by serious cases.
The flu hotline launched recently, which uses non-medical staff to diagnose swine flu in callers and prescribe them antiviral drugs, is a scaled-down and interim version of the planned flu service. The report says the committee has "significant concerns" about the delay in putting the full enhanced service into operation. It invites the government to explain the hold-up.
"We also seek reassurance that the enhanced service will be able to meet anticipated demand and that it will be fully operational in the autumn, in good time to meet the challenges of the anticipated second wave of influenza," the report says.
The committee also wants the government to state clearly whether the flu hotline is a separate enterprise or part of NHS Direct. "If separate, we invite the government to set out the cost-benefit analysis underpinning that decision."
Some parts of the government's planning are praised in the report, such as the stockpiling of enough antiviral drugs to treat half the population and the advance contracts signed with drug companies to supply a vaccine against swine flu as early as possible.
But, said committee chairman Lord Sutherland, "there are other areas where we appear to be under-prepared".
Critical care services in hospitals for the seriously ill could come under great strain. The report cites evidence from Dr Bruce Taylor, consultant in intensive care medicine, who "expressed with some force his concern about provision for critical care in the event of a pandemic".
Taylor also raised the ethical dilemma for NHS staff who may have to make hard choices between one patient and another in the face of a shortage of beds or life-saving equipment.
The then health secretary Alan Johnson and the national director of pandemic influenza preparedness, Prof Lindsey Davies, both told the committee that intensive care may struggle to cope. "There will be huge pressures on intensive care in a pandemic … It would never be possible to provide unlimited intensive care facilities … that is not practical," said Davies.
Other areas of concern included the absence of "whole system" testing, to find out whether all parts of the NHS, including the ambulance service, GPs, hospitals and mental health service, can work well together under the strain of mass illness.
The Conservatives and Liberal Democrats claimed the report substantiated their worries about the second wave. "The report raises serious questions about ongoing preparedness which the government must answer in full," said Stephen O'Brien, shadow health minister.
Norman Lamb, the Liberal Democrat health spokesman, said: "Ministers are desperately trying to divert attention away from the fact that Whitehall infighting meant the full national flu line was not up and running when it should have been, leaving doctors and nurses without the support they needed." The health secretary, Andy Burnham, welcomed a "well-timed" report.
"We will give it careful consideration and it will help inform our response to this pandemic," he said. "We are pleased that the report recognises the extent of our pre-pandemic plans and the steps we have taken to prepare the NHS, stock antivirals, order vaccine and ensure the public has quick access to treatment.
"The report endorses the decision to activate the National Pandemic Flu Service. Given that it was a major undertaking for the NHS to mobilize a national network of distribution points, we were always clear that it would only be justified when there were widespread levels of flu-like illness across the country."
The science and technology committee, which has been holding hearings as the pandemic has evolved over recent months, expressed disquiet over some aspects of the government's preparations in an incisive report.
The committee was particularly concerned by delays in the rollout of the full National Pandemic Flu Service, which is supposed to take the strain off GPs, and the possibility of a shortage of beds and staff in hospital intensive and critical care units, which could be overwhelmed by serious cases.
The flu hotline launched recently, which uses non-medical staff to diagnose swine flu in callers and prescribe them antiviral drugs, is a scaled-down and interim version of the planned flu service. The report says the committee has "significant concerns" about the delay in putting the full enhanced service into operation. It invites the government to explain the hold-up.
"We also seek reassurance that the enhanced service will be able to meet anticipated demand and that it will be fully operational in the autumn, in good time to meet the challenges of the anticipated second wave of influenza," the report says.
The committee also wants the government to state clearly whether the flu hotline is a separate enterprise or part of NHS Direct. "If separate, we invite the government to set out the cost-benefit analysis underpinning that decision."
Some parts of the government's planning are praised in the report, such as the stockpiling of enough antiviral drugs to treat half the population and the advance contracts signed with drug companies to supply a vaccine against swine flu as early as possible.
But, said committee chairman Lord Sutherland, "there are other areas where we appear to be under-prepared".
Critical care services in hospitals for the seriously ill could come under great strain. The report cites evidence from Dr Bruce Taylor, consultant in intensive care medicine, who "expressed with some force his concern about provision for critical care in the event of a pandemic".
Taylor also raised the ethical dilemma for NHS staff who may have to make hard choices between one patient and another in the face of a shortage of beds or life-saving equipment.
The then health secretary Alan Johnson and the national director of pandemic influenza preparedness, Prof Lindsey Davies, both told the committee that intensive care may struggle to cope. "There will be huge pressures on intensive care in a pandemic … It would never be possible to provide unlimited intensive care facilities … that is not practical," said Davies.
Other areas of concern included the absence of "whole system" testing, to find out whether all parts of the NHS, including the ambulance service, GPs, hospitals and mental health service, can work well together under the strain of mass illness.
The Conservatives and Liberal Democrats claimed the report substantiated their worries about the second wave. "The report raises serious questions about ongoing preparedness which the government must answer in full," said Stephen O'Brien, shadow health minister.
Norman Lamb, the Liberal Democrat health spokesman, said: "Ministers are desperately trying to divert attention away from the fact that Whitehall infighting meant the full national flu line was not up and running when it should have been, leaving doctors and nurses without the support they needed." The health secretary, Andy Burnham, welcomed a "well-timed" report.
"We will give it careful consideration and it will help inform our response to this pandemic," he said. "We are pleased that the report recognises the extent of our pre-pandemic plans and the steps we have taken to prepare the NHS, stock antivirals, order vaccine and ensure the public has quick access to treatment.
"The report endorses the decision to activate the National Pandemic Flu Service. Given that it was a major undertaking for the NHS to mobilize a national network of distribution points, we were always clear that it would only be justified when there were widespread levels of flu-like illness across the country."
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