Category Business Continuity Management Briefing BCM - BCM & Risk Management - H5N1 - Pandemic - General
Doctors' leaders today warned that flaws in the government's plans to deal with a flu pandemic could cause chaos in the event of an outbreak.
Senior public health experts and family doctors said the plan to let local councils and NHS trusts decide how to deal with a pandemic could lead to some areas not getting drugs to treat those infected.
Dr Richard Coker, of the London School of Hygiene and Tropical Medicine, said the government's plan failed to address how scarce vaccines and anti-viral drugs would be shared out.
He raised concern that giving local authorities too much say over how to respond to a pandemic might lead to drugs being used up in the first area hit by an outbreak.
"If the pandemic is severe, then stocks of scarce resources will run out fairly quickly and my concern is that you shift resources around to areas where the epidemic is hitting hard," he told BBC Radio 4's Today programme.
"Say it hits London first and you move supplies from Manchester down to London and then the epidemic hits Manchester and Manchester has insufficient resources."
He also said guidance was needed about who should be prioritised for treatment in the event of a pandemic, given there would not be enough drugs for the whole population.
In an article in the latest edition of the British Medical Journal, Dr Coker said Britain's preparations for a pandemic were more advanced that those of many other European countries. But he said considerable improvements were still required.
His concerns about the government's preparedness are shared by the British Medical Association.
Dr Peter Holden, the BMA GPs committee's lead on pandemic flu planning, said it was "nonsense" to leave local councils to lead the response to a pandemic.
The GP said: "Infections obey no local administrative boundaries. All you will get is chaos if you have 150 different ways to approach an outbreak."
Dr Holden suggested that ministers were "petrified" by the prospect of an outbreak and wanted to "shift the balance of blame" if plans failed on to local councils.
"I'm finding the level of indecision within government quite frightening. No one is prepared to say who is in control. No one is prepared to take command because with command comes responsibility and accountability," he said.
Dr Richard Jarvis, the deputy chairman of the BMA's public health committee, agreed that there was "no real plan" in place regarding what to do if there was a shortage of flu drugs.
"It's very important that individual doctors and nurses have some sort of regional and national plan to fall back on," he said.
"Given there are likely to be [drug] supply issues, clinicians should have protocols about who to prioritise for treatment. If patients don't meet certain criteria they don't get the drugs."
Dr Jarvis said a system to alert local areas about the spread of outbreaks across the country was needed. "It's not fully in place but it is getting better," he said.
However, Professor Rod Griffiths, president of the Faculty of Public Health, warned against too much central government control of the response to a pandemic.
"If you have a flu outbreak in Manchester, it's going to be bloody hard to convince people in London that something needs doing," he said.
In the worse case scenario, a flu pandemic would cause 750,000 excess deaths in the UK and cost the country around £170bn, according to the Department of Health.
Prof Griffiths said a not particularly lethal form of flu was most likely to cause major disruption and strain to the health service.
"A flu that isn't too fatal - with say a 1% to 2% fatality rate - will spread far more easily because people will struggle on. Whereas if the flu is much more deadly people will stay at home, which would limit the spread of infection," he said.
A Department of Health spokeswoman said its flu pandemic strategy was currently out for consultation and a final document would be published later this year.
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