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Richard,

I don't agree with the above

First, it is very difficult to define failure in such cases. What is failure for you? If you have 500 deaths instead of 200? Or 10,000 instead of 7,000?

Second, the local managers should not be made scapegoats, not when they follow the ever-changing guidance from the top. Remember that the HPA algorithm re H1N1 has changed 6 times in one month. What does this tell you?

Third, I don't believe that DH has fears in regards to the local plans. DH has and does receive regular assurance that plans are in place and ready so, honestly, I have no idea who is your source any why is so misleading.

There is more to say but I will stop here, of course, I don't expect you to reconsider you article although it may be appropriate to do so.

Regards,

Costin