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NHS in crisis Monday, 11 January, 1999, 19:45 GMT
The crisis of winter present
The nursing shortage is the extra factor in this year's winter crisis
The flu outbreak this winter is worse than last year, but no worse than in many other years, according to flu monitoring services.

NHS in crisis
The outbreak has not officially reached epidemic proportions.

The Royal College of General Practitioners' (RCGP) flu monitoring unit says the national incidence of the flu is 185 cases per 100,000 cases as of the beginning of January.

This is likely to have risen as the outbreak reaches its peak in the second week of January.

The RCGP says there would have to be 400 cases per 100,000 for the situation to be considered "unusual".

It no longer uses the term epidemic to describe a severe outbreak.

The main problem this year has been a combination of factors, including bed shortages and staff problems.

Waiting lists

Some health workers have argued that the government's concentration on getting waiting lists down has caused the problem.

But a survey by the NHS Confederation, which represents NHS managers, says hospitals are suspending non-urgent operations to cope with the extra emergency admissions.

The virus is thought to have a five-week life span and is hitting some areas worse than others, causing what one manager called "spikes of demand".

The Midlands was badly hit, with two hospitals having to use refridgerated lorries as mortuaries because of lack of space and some doctors working double shifts.

One crematorium in Nottingham was forced to use floodlights to fit in more services and another held Saturday services.

Death rates over two weeks of the Christmas break were at 520, compared with 200 for the same period in 1998.

In Portsmouth, relatives and friends of hospital patients were asked to wash, shave and feed them to relieve pressure on staff.

And in Torbay, hospital managers issued an urgent appeal for people with nursing qualifications to come forward because of staff shortages.

In the North, most routine surgery was cancelled, but Scotland escaped relatively unscathed.

People most at risk from the flu include the elderly, the very young, asthmatics, diabetics and those with a damaged immune system.

The young have been particularly susceptible. At the beginning of January, there were 164 cases of flu per 100,000 people in children under four and 103 cases per 100,000 in those aged between five and 14.

This compares to 93 cases per 100,000 in the 15-64 age group and 67 cases per 100,000 in people over 65.

Bed numbers

The NHS Confederation says there are many factors which have led to the current crisis.

These include nursing recruitment problems and a 10-year rise in emergency admissions, but the main problem is a shortage of beds.

In January, the Emergency Bed Service issued a warning about bed shortages for the first time in its two-year history.

It said there were only a handful of additional beds available in England for hospitals which had reached capacity levels.

Bed numbers have been cut around the country as part of efficiency savings by hospitals.

The cuts began under the Conservatives. In some cases, hospitals have mothballed entire wards.

Many health authorities and hospitals have gone over budget in recent years and each year the problem gets worse as the budget deficits accumulate, leading to more cuts.

The government has ordered a review of bed numbers which will report in the Spring.

See also:

05 Jan 99 | Health
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