Claims that the NHS was on the verge of crisis helped break the petrol tankers' blockades. Was the health service used and abused? Lyn Whitfield and Mark Gould investigate

It started with a handful of lorry drivers and farmers blockading a couple of oil refineries the weekend before last.

Yet by mid-week it was the great British fuel crisis of 2000 and the NHS was in grave danger.

At least, that was how it was according to health secretary Alan Milburn, who told the nation at 4pm on Tuesday 12 September: 'I have this afternoon instructed local NHS services to put into place their emergency planning procedures.

'Those involved in this blockade need to know the very serious effect their actions are having on the NHS. (They) have made their point. Enough is enough. '

If Mr Milburn hoped Britain would rally around as the government deployed Army tankers around the country, his hopes were soon shattered.

Shadow health secretary Dr Liam Fox responded by accusing the government of overplaying the NHS's problems to turn the public against the blockaders.

Dr Fox appeared to have solid ground for his attack. Before Mr Milburn's near-Churchillian statement, the Department of Health had issued a press release saying the NHS was under 'massive pressure'. This was backed by a regional breakdown of 'examples of pressure on health and social services arising from the current fuel shortage'.

This included claims that Alder Hey Hospital in Liverpool was experiencing problems with drug deliveries, that Birmingham Women's Hospital and Bart's Hospital in London had cancelled operations, that Papworth Hospital had blocked beds because relatives could not collect patients, and that Hull Royal Infirmary had run out of sutures.

All the claims were subsequently denied, with Birmingham Women's Hospital faxing the Press Association to say it had 'NOT, repeat NOT, cancelled any operations' and was indeed 'running normally at present'.

Bolton Hospitals trust was also said to be 'under severe pressure from high emergency admissions'.

But spokeswoman Heather Edwards told HSJ it did not believe this was related to the fuel problem and it was 'very puzzled'by its entry on the list.

The DoH said Royal Preston Hospital trust had delayed discharges because of lack of patient transport. But a spokesperson for the trust says this did not happen and it was providing a 'near normal service'.

On the other hand, earlier in the week the trust had been very concerned about whether social services would be able to operate.

This concern that services could be affected seems to have become a positive statement that they were being affected at some point in the chain from trust to health authority to region to DoH press office.

Where HSJ was able to get any explanation for the mistaken accounts of services being affected, they tended to be blamed on similar 'Chinese whispers' or on human error. Cock-up, rather than conspiracy, in other words.

North West regional office spokesman Hugh Lamont says it would have received information from Bolton in one of its thrice-daily situation reports and passed it on to the DoH 'in good faith'.

A spokesperson for Hull and East Yorkshire Hospitals trust says it held a meeting about theatre supplies generally and was then contacted by Northern and Yorkshire regional office, which had heard the trust was out of sutures. This rumour must have passed up the line.

But a London regional office spokesman admits he caused a 'communications foul-up' between region and the DoH over the situation at Bart's.

And in Birmingham, HA spokeswoman Christine Ransome-Wallis says regional office admitted it was responsible for sending incorrect information to London, although in the 'welter of information' it could not work out where the error arose.

Still, there is no doubt that the government was anxious to hammer home the message that the NHS was suffering. This opened it up to Dr Fox's attacks - and a good deal of mistrust on the part of the fuel protesters.

As the stranglehold started to lift on Thursday, at least one blockade was briefly reinstated by demonstrators claiming the government had misled them about the health service's problems, Inevitably, given the size and diversity of the NHS, the actual situation was patchy. In London, regional office says only two hospitals - King George's in Ilford and West Middlesex - considered 'curtailing some activity'.

United Bristol Hospital trust was forced to postpone all non-emergency surgery as late as last Thursday.

West Country Ambulance Service trust reported 'no problems at all', while the Welsh ambulance service had to move to an emergency-only service almost as soon as the blockades started.

Mersey Ambulance Service trust put its millennium plans into effect and fuelled other NHS organisations and their staff.

Mike Jackson, director of operational services, says there was 'no crisis in terms of 999 calls', but arranging the refuelling had been a 'logistical nightmare'.

Organising fuel so that staff could get to work - and community workers and GPs could do their jobs - was one of the key issues in many regions. Some rural areas were hit hard, however.

A spokesperson for Morecambe Bay Hospitals trust said it faced double problems - pumps running dry in the Barrow-in-Furness area on Sunday, before most people had heard there was a 'crisis' - and running three hospitals spread across 1,000 square miles of countryside.

With social services staff hit as well as health workers, the trust had to cancel 'about 100'nonemergency operations because of bed blocking.

In areas where there were problems, suggestions that Mr Milburn had been 'scaremongering' were met with fury.

Professor John Ashton, director of public health for North West region, said of Dr Fox's comments: 'I don't think it is very noble of someone with medical qualifications to make these sort of accusations. '

The political mud-slinging is likely to start again if waiting lists rise and the government attributes this to the fuel blockade.

But a spokesperson for Morecambe Bay trust calculates that even if it runs additional evening lists it will take a month to clear 100 cancelled operations.

Roll on winter.