While the country struggled along in grudging acceptance of the fuel blockade, two regional public health directors tackled the picket lines head on.

Professor John Ashton and Dr Gabriel Scally told pickets that the blockade was causing serious problems for NHS staff and patients.

Professor Ashton, from North West regional office, decided to visit Stanlow refinery in Cheshire on Wednesday last week after he was presented with a two-page dossier of problems across his region.

'I had quite a friendly chat with some of the drivers, but I got a lot of violent abuse from others - mostly just obscenities - things that you couldn't print in a family journal. I also heard accusations of lying and so on - some of them really didn't want to hear the full picture. '

Pickets were told of delayed funerals because undertakers couldn't collect bodies, a build-up of clinical waste, community staff unable to get to work, cancelled lists, and a range of public health infrastructure problems.

'I tried to get across the point that it wasn't just about the ambulance service getting petrol - everything in the NHS is interconnected.

'I think what I said had an impact on many of the pickets who were decent human beings and didn't want to cause problems - others were people who you just wouldn't want to meet on a dark night. '

At Avonmouth refinery in the Severn Estuary, Dr Scally, South West region's director of public health, told pickets about the potential damage that they could be doing to the NHS.

He said. 'I think that the message got home to some of them. They were respectful. They listened. We had a frank exchange of views. '