NHS in Crisis: National View - Flu exposes chronic staff shortages

THE PRESSURE exerted on the NHS by the flu outbreak is being caused by problems dating back years, health managers said yesterday.

The real crisis is a staff shortage, caused by an erosion in pay and compounded by fewer beds. Sydney and Peking flu have only served to bring the crisis to the public's attention.

Britain is far from a flu epidemic. Stephen Thornton, chief executive of the NHS Confederation, representing health authorities and trusts, said they faced the problem of flu most years. The unique factor now was the staff shortage.

There is an estimated 8,000 shortfall of nurses, and a lack of paramedics, physiotherapists and speech therapists. "I can't remember a time in the last few years when it has been so difficult right across the country. That is the special ingredient," he said. "The Government has given us extra money, but in some parts of the country we can't spend it. We just can't recruit the staff."

Kingston Hospital, in Kingston upon Thames, is one of many to have looked abroad. The first of nearly 50 nurses from the Philippines started work there this week.

Britain is not producing enough nurses: last year the number of trainee places exceeded applicants. And there is a difficulty dating from the early Nineties, when the number of training places was halved in a recession.

A spokesman for New Cross Hospital, Wolverhampton, said: "Staff have been working double shifts, 16 hours at a time, throughout the Christmas and New Year period."

Many nurses have left the profession because they can earn more elsewhere. "Nurses tell us that fair pay is the number-one factor which would encourage them to stay in nursing," said Christine Hancock, general secretary of the Royal College of Nursing.

Bed occupancy rates are another factor in the crisis. Mr Thornton said: "Hospitals have been working increasingly to full capacity all year round. There is nothing more inefficient than an empty bed, and occupancy rates are running at 90 per cent plus. But then you don't need very much of an increase in demand to create real problems."

Philip Monk, a public health consultant in Leicestershire health authority, said there was a "very high level of consultation on influenza-like illnesses". Some really were flu, others were respiratory syncitial virus, which, may make asthma worse and raise temperatures.

A third factor was the peaking of the regular four-yearly cycle in the incidence of mycoplasma, a bug that causes chest infections. "A lot of people are very acutely ill," he said. "There are a phenomenal number of people calling for the GP, which means GPs are taking longer to get to them and people are going down to hospital, which isn't helping the situation. People are trying to find a short cut ... when there are no short cuts to be had."

Douglas Fleming, of the infectious diseases monitoring unit at the Royal College of General Practitioners, said most calls were unnecessary, and accused the many "worried well" of selfishness.

Hugh Lamont, spokesman for the North West Region Ambulance Services, covering Manchester and Liverpool, said: "The system was overrun. The next stage for people was to dial 999 and call an ambulance. The hospitals were acting as clearing houses for primary care and also dealing with the more serious cases." At Walsall Manor Hospital, in the West Midlands, 278 emergency admissions were treated over four days last week, an increase of 100 on the same week in the previous year.

All non-urgent operations in the Sandwell Health Authority area of the Black Country have been cancelled because of the outbreak. It has spread across the West Midlands: at a Wolverhampton hospital, 100 people waiting for treatment were put on stand-by as doctors struggled to cope with demand from flu sufferers. In south Wales, hospitals were under growing pressure. The only part of Britain to have escaped is the South-west. Scotland has been relatively mildly affected.

n A pounds 1m national advertising campaign was launched yesterday to recruit blood donors. The hard-hitting adverts are in response to recent statistics, which showed that less than 6 per cent of the eligible population gives blood.