SENIOR public health doctors have written to the The Lancet disputing its claim that Ireland is well prepared to cope with an outbreak of pandemic bird flu.

Last month the British medical journal published a survey stating Ireland’s emergency plan for dealing with bird flu was among the best in Europe. Ireland topped the poll, with 70 out of a possible 80 points, in a study conducted by the London School of Hygiene and Tropical Medicine. The European average was 54.

Irish health authorities were understandably proud.The study was welcomed by the Health Service Executive (HSE), which is in charge of preparations and has drawn up 100 implementation actions in the event of an outbreak.

But in an act that might be regarded as unpatriotic, the findings have been rejected by the public health doctors’ committee of the Irish Medical Organisation (IMO), which last week wrote to The Lancet pointing out flaws in Ireland’s bird flu strategy.

“Paper plans and plans in practice are two entirely different matters,” said Christine O’Malley, president of the IMO, who claims Ireland is as unprepared for a bird flu outbreak as it was for Sars three years ago.

“We don’t actually know what the government’s plans are as they have not been tested. We have no plans in place if bird flu hits after office hours or at the weekend because we have no 24-hour system or doctors on call. Our hospitals are already in crisis, with people stranded on trolleys for days waiting for treatment. If the hospital system can’t cope now, what chance do we stand during a pandemic?”

If published by The Lancet, the letter will embarrass the government, which has been in a 10-year dispute with public health doctors. Because of the dispute, over pay and conditions, Ireland has no 24-hour system to protect against outbreaks of disease such as Sars or biological terrorism.

“Plans are irrelevant if they don’t work in practice,” said Richard Coker of the London School of Hygiene and Tropical Medicine, who led the study of 21 countries.

“If a pandemic is as bad as predicted, health services have to respond very quickly. Sars was just a dry run. That virus was more easily controlled because the incubation period was longer, but with pandemic flu you don’t have as much time to put your plans into action. Public health officials are critical to these plans.”

Coker analysed pandemic flu plans of 25 EU member states, as well as Bulgaria, Romania, Norway and Switzerland. They were assessed by reference to planning and co-ordination, surveillance, public health interventions, health system responses, maintenance of essential services, communication and putting plans into action. National scores ranged from 24 points to 80.

Although Ireland scored well in key areas, it was awarded only 35 points for its plans for maintaining essential services once an outbreak hits. Ireland also scored less than 40 for public health interventions.

Two years ago, serious weaknesses in Ireland’s plans to combat a flu outbreak were exposed when Irish holidaymakers suspected of catching avian flu in Beijing were allowed to leave Dublin airport without being assessed. No public health officials were available because the flight landed on a weekend.

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