Press: The flu news epidemic
Authors: K. Abbasi
Journal: BMJ (2000)

In the end we weren't prepared for it. Sidney A, the real millennium bug—not a computer glitch but an influenza virus—was at the centre of a furore over its true extent and its impact on the NHS. The media generously fanned the flames. But once again New Labour's spin kings were thought to be behind the headlines.

Two key questions arise from the past fortnight's exhaustive media coverage. Was it really a flu epidemic? And, whether it was or not, why was the NHS unable to cope?

Before the millennium holiday the government had said that it was prepared for a surge in emergency admissions. As it turned out, the holiday period was not exceptionally busy for hospitals.

On 4 January, however, there were signs that the lull was about to end. “Britain's Y2K flu bug is due to peak this week as the country heads for its worst epidemic since 1989 when 29,000 died,” observed Jill Palmer in the Mirror. “Calls to NHS Direct, the national nurse-led helpline, have soared from 4,000 to 14,000 a day. Meanwhile, pharmacists have reported a fourfold increase in the number of customers asking for cold and flu remedies and painkillers.”

Figures for calls to NHS Direct varied: other newspapers put it closer to 20,000 a day. But none of the early reports suggested the figures were of epidemic proportions. The only outstanding statistic, noted the Daily Telegraph, was that “family doctors dealt with a record number of calls over the holiday, with an estimated 2 per cent of the population contacting a GP.”

By 6 January the Daily Telegraph was indignant (“Flu outbreak leaves only 11 beds free for intensive care”) and claimed that almost every family was affected by the flu virus. NHS horror stories gathered apace. Northwick Park Hospital hired a St John Ambulance bus “to ease the backlog of accident and emergency patients” (Mirror, 6 January). Eastbourne Hospital had to store 60 dead bodies in a refrigerated lorry (Daily Telegraph, 7 January). A 74 year old man died after an emergency aortic aneurysm repair and a subsequent 200 mile drive in search of an intensive care bed (Independent, 8 January). And, sacre bleu: “NHS ask France to take our flu victims” (Sun, 7 January). No! How could it be?

But the government was, as yet, unfazed. “Officials played down the use of lorries [for storing bodies] and said it was not ‘an emergency reaction. It was part of our unprecedented long-term winter planning exercise, given the circumstances of the extended millennium holiday,’ said a Department of Health spokesman,” reported the Independent (8 January).

The Guardian (8 January) whiffed the hysteria and argued that the government's reforms should be given more time: “Crises in the NHS have become as much part of the post-Christmas New Year season as the moulting Christmas tree and the left-over turkey soup. We are currently being bombarded with NHS disaster stories . . . All this is grist to the mill for various interested parties, keen to prove a point.”

On 8 January, the flu outbreak was not an epidemic; demand on primary care and hospital services was heavy, but officially the NHS was coping. And the media, wanting to stay occupied after the damp squib of the millennium bug, had found an easy target in the NHS. Overnight, however, everything mysteriously changed.

“Britain is in the grip of a serious flu epidemic, the government has declared. The outbreak is forcing hospitals to cancel thousands of urgent operations and is leading to an overcrowding crisis amid scenes of chaos in wards,” revealed the Observer (9 January). The source of this claim was said to be Professor Liam Donaldson, England's chief medical officer. The official figures, he argued, were an underestimate because thousands of flu victims were calling NHS Direct and not going to see their GPs or attending casualty departments.

Alan Milburn, the health secretary, hummed the same tune in the Daily Telegraph (11 January): “Unless present levels of influenza activity peak soon, we would be heading for the worst epidemic in the last decade.” If the figures didn't support the government line, what was his evidence? “That chimes with most people's experiences. There can hardly be a family in the land that has not been affected by the flu.” Really? And what does that actually mean for the NHS?

But on this occasion the medical experts weren't falling for New Labour's spin; the official figures fell well short of an epidemic, and newspaper columnists reacted quickly. Charles Arthur asked: “If the NHS is coping so well, why are all those extra beds needed, why has an epidemic-that-is-not-an epidemic been declared, and why are routine operations being cancelled all over the country?” (Independent, 11 January).

By 16 January, the government was reeling from the media and public backlash, including an attack on its handling of the NHS by its own high profile peer Lord Winston. In response, Prime Minister Tony Blair could do little more than promise further investment in the NHS.

The government's attempt to mask the problems of the NHS had clearly failed. The Observer (16 January) offered an insight: “The reason the government was talking up a flu epidemic was simple. Reports to the NHS executive suggested elective surgery was grinding to a halt and the number of spare beds was close to zero.” Government officials, said the newspaper, had “made discreet calls to Sunday newspapers.” And the reason for this media manipulation? “Health Secretary Alan Milburn,” revealed the Observer, “one of the most media-savvy Cabinet Ministers, knew that the NHS was about to go on to the political front line.”

So, it wasn't an epidemic. No different from most other years, and the NHS had coped poorly. But, at least on this occasion, New Labour's spin had been publicly unravelled.